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PACIFIC CENTRAL COAST HEALTH CENTERS NPI 1831544311


NPI Information

NPI: 1831544311
Provider Name: PACIFIC CENTRAL COAST HEALTH CENTERS

Doing Business As: MED PLUS PISMO BEACH

Classification: Clinic/Center - 261QC1500X
Entity Type: Organization

Specialization: Community Health

CLIA Number: 05D2115785

Address:
877 OAK PARK BLVD
PISMO BEACH, CA
ZIP 93449
Phone: (805) 474-8450
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PACIFIC CENTRAL COAST HEALTH CENTERS is a community health clinic center in Pismo Beach, CA. PACIFIC CENTRAL COAST HEALTH CENTERS NPI is 1831544311. The provider is registered as an organization entity type.
The provider Is Doing Business As Med Plus Pismo Beach.

The provider's business location address is:

877 OAK PARK BLVD
PISMO BEACH, CA
ZIP 93449-292
Phone: (805) 474-8450
Fax: (805) 466-4862

The provider's authorized official is Matthew Richardson .
The authorized official title is Chief Financial Officer and has the following contact phone number (805) 739-3108.

The CLIA number assigned to this NPI record is 05D2115785 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/3/2016 and was last updated on 12/7/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QC1500XClinic/CenterCommunity HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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