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General NPI Number Information
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NPI Number | 1609096882
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Entity Type | Organization
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Legal Business Name | CENTRAL COAST IN-PATIENT CONSULTANTS, INC.
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1400 EAST CHRUCH STREET
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City | SANTA MARIA
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State | CA
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Zip | 93456-5906
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Country | US
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Telephone | 805-739-3000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 188
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City | OAKDALE
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State | CA
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Zip | 95361-0188
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Country | US
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Telephone | 209-845-1346
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | BRYAN Y WILLIAMSON
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Credential |
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Telephone | 209-845-1346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | FNP35858
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License Number State | CA
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Taxonomy #2
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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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