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General NPI Number Information
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NPI Number | 1306375837
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Entity Type | Organization
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Legal Business Name | CENTRAL COAST CARDIOVASCULAR ASC LLC
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 2000 OUTLET CENTER DR STE 225
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City | OXNARD
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State | CA
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Zip | 93036-0605
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Country | US
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Telephone | 805-258-5420
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Fax | 805-628-9446
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Provider Business Mailing Address
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Address Line | 100 N BRENT ST STE 201
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City | VENTURA
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State | CA
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Zip | 93003-2835
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Country | US
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Telephone | 805-620-3499
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Fax | 805-643-3331
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. TAREN CESSNA
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Credential |
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Telephone | 805-620-3499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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