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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)

General Provider Information

NPI Number : 1447277355
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 : 93458-7310
Country : US
Telephone Number : 805-361-8028
Fax Number : 805-361-8097
Provider Business Practice Location Address
First Line : 2801 SANTA MARIA WAY
Second Line : BLDG A & B
City : SANTA MARIA
State : CA
Zip : 93455-2118
Country : US
Telephone Number : 805-934-5400
Fax Number : 805-938-9207
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 : 01/21/2019

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

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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