Healthcare Provider Details

I. General information

NPI: 1427372226
Provider Name (Legal Business Name): CENTRAL COAST URGENT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2010
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

783 QUINTANA RD
MORRO BAY CA
93442-1966
US

IV. Provider business mailing address

PO BOX 727
MORRO BAY CA
93443-0727
US

V. Phone/Fax

Practice location:
  • Phone: 805-771-0108
  • Fax: 805-771-0111
Mailing address:
  • Phone: 805-771-0108
  • Fax: 805-771-0111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberA34991
License Number StateCA

VIII. Authorized Official

Name: DR. ERIC N SORENSEN
Title or Position: PRESIDENT
Credential: M. D.
Phone: 805-771-0108