| Central California Movement Disorders | |
|
320 James Way Ste 210 Pismo Beach CA 93449-2875 | |
| (800) 462-3732 | |
| Not Available |
| Full Name | Central California Movement Disorders |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 320 James Way Ste 210, Pismo Beach, California |
| Authorized Official Name and Position | Brent Robert Bluett (PRESIDENT) |
| Authorized Official Contact | 4153781485 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central California Movement Disorders 60 El Viento Pismo Beach CA 93449-2853 Ph: (415) 378-1485 | Central California Movement Disorders 320 James Way Ste 210 Pismo Beach CA 93449-2875 Ph: (800) 462-3732 |
| NPI Number | 1003577644 |
|---|---|
| Provider Enumeration Date | 01/05/2022 |
| Last Update Date | 02/09/2022 |
| Certification Date | 02/09/2022 |
| Medicare PECOS PAC ID | 9830584861 |
|---|---|
| Medicare Enrollment ID | O20220309002575 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003577644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Brent R Bluett |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669772331 PECOS PAC ID: 4183932213 Enrollment ID: I20180927003174 |
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