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General NPI Number Information
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NPI Number | 1295605475
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Entity Type | Organization
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Legal Business Name | CENTRAL COAST NURSING HOME PHYSICIANS, INC.
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Dates
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Enumeration Date | 11/11/2025
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 1405 E MAIN ST
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City | SANTA MARIA
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State | CA
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Zip | 93454-4801
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Country | US
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Telephone | 805-978-4149
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Fax |
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Provider Business Mailing Address
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Address Line | 1375 E GRAND AVE STE 103
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-2421
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Country | US
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Telephone | 805-474-5620
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | AHMAD NOORISTANI
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Credential | MD
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Telephone | 805-821-1176
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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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