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General NPI Number Information
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NPI Number | 1033418736
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Entity Type | Organization
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Legal Business Name | CENTRAL COAST ASSOCIATED PHYSICIANS, INC.
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Dates
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Enumeration Date | 03/21/2011
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Last Update Date | 05/26/2016
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Provider Practice Location Address
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Address Line | 1220 LAS TABLAS RD SUITE 1418
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City | TEMPLETON
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State | CA
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Zip | 93465
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Country | US
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Telephone | 805-434-4315
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Fax | 805-434-4314
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Provider Business Mailing Address
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Address Line | PO BOX 748133
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City | LOS ANGELES
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State | CA
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Zip | 90074-8133
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Country | US
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Telephone | 805-434-4315
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Fax | 805-434-4314
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Authorized Official
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Title or Position | SOLE INCORPORATOR
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Name | DR. RONALD KAUFMAN
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Credential | M.D.
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Telephone | 714-428-6812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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