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General NPI Number Information
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NPI Number | 1508105008
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC
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Dates
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Enumeration Date | 02/05/2013
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Last Update Date | 01/23/2019
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Provider Practice Location Address
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Address Line | 4711 HIGHWAY 166
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City | NEW CUYAMA
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State | CA
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Zip | 93254-0000
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Country | US
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Telephone | 661-766-2149
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Fax | 661-766-2350
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Provider Business Mailing Address
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Address Line | 2050 S BLOSSER RD
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City | SANTA MARIA
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State | CA
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Zip | 93458-7310
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Country | US
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Telephone | 805-361-8014
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Fax | 805-361-8097
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | BARBARA ALLEN
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Credential |
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Telephone | 805-361-8014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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