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CENTRAL COAST VASCULAR INC. NPI 1891855193


NPI Information

NPI: 1891855193
Provider Name: CENTRAL COAST VASCULAR, INC.
Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

CLIA Number: 05D2155097

Address:
100 N BRENT ST
SUITE 201
VENTURA, CA
ZIP 93003
Phone: (805) 643-3300
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CENTRAL COAST VASCULAR, INC. is a vascular surgery surgery in Ventura, CA. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. CENTRAL COAST VASCULAR, INC. NPI is 1891855193. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

100 N BRENT ST
SUITE 201
VENTURA, CA
ZIP 93003-822
Phone: (805) 643-3300
Fax: (805) 643-3331

The provider's authorized official is Christopher Shawn Skillern .
The authorized official title is President and has the following contact phone number (805) 643-3330.

The CLIA number assigned to this NPI record is 05D2155097 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/10/2006 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12086S0129XSurgeryVascular SurgeryYes

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: 4/28/2024

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