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NPI Code Detail

MEDICARE: COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC

MEDICARE: COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2ZZZ08362ZOTHERCABLUE SHIELD OF CA
3HAP70936FOTHERCAFAMILY PLANNING
4BCP70936FOTHERCANCER DETECTION PROGRAM

General Provider Information

NPI Number : 1275550295
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC
Provider Business Mailing Address
First Line : 2050 S BLOSSER RD
Second Line :
City : SANTA MARIA
State : CA
Zip : 93458
Country : US
Telephone Number : 805-361-8028
Fax Number : 805-361-8097
Provider Business Practice Location Address
First Line : 1330 LAS TABLAS RD STE A
Second Line :
City : TEMPLETON
State : CA
Zip : 93465-9758
Country : US
Telephone Number : 805-434-1038
Fax Number : 805-434-1659
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : RONALD E CASTLE
Credential :
Telephone Number : 805-929-3211
Provider Enumeration Date : 07/16/2006
Last Update Date : 12/12/2023

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Directions to “COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC ” Practice Location

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