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1881785764 NPI number — UROLOGY ASSOCIATES OF THE CENTRAL COAST

NPI Number: 1881785764
Health Care Provider/Practitioner: UROLOGY ASSOCIATES OF THE CENTRAL COAST

Information about “1881785764” NPI (UROLOGY ASSOCIATES OF THE CENTRAL COAST) exists in 1881785764 in HTML format HTML  |  1881785764 in plain Text format TXT  |  1881785764 in PDF (Portable Document Format) PDF  |  1881785764 in an XML format XML  formats.

NPI Number : 1881785764 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1881785764",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "UROLOGY ASSOCIATES OF THE CENTRAL COAST",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "225 PRADO RD",
    "SecondLineMailingAddress": "SUITE D",
    "MailingAddressCityName": "SAN LUIS OBISPO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "93401",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "805-786-2500",
    "MailingAddressFaxNumber": "805-781-0423",
    "FirstLinePracticeLocationAddress": "225 PRADO RD",
    "SecondLinePracticeLocationAddress": "SUITE D",
    "PracticeLocationAddressCityName": "SAN LUIS OBISPO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "93401-7363",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "805-786-2500",
    "PracticeLocationAddressFaxNumber": "805-781-0423",
    "EnumerationDate": "09/27/2006",
    "LastUpdateDate": "10/23/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CANFIELD",
    "AuthorizedOfficialFirstName": "CRAIG",
    "AuthorizedOfficialMiddleName": "W",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "805-541-1111",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QX0203X",
          "TaxonomyName": "Radiation Oncology Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208800000X",
          "TaxonomyName": "Urology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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