| Central Coast Neurology Medical Group, Inc | |
|
1035 Peach St Suite 204 San Luis Obispo CA 93401-2700 | |
| (805) 544-7511 | |
| (805) 544-7560 |
| Full Name | Central Coast Neurology Medical Group, Inc |
|---|---|
| Speciality | Psychiatry & Neurology - Clinical Neurophysiology |
| Location | 1035 Peach St, San Luis Obispo, California |
| Authorized Official Name and Position | Mary S Amir (PRESIDENT) |
| Authorized Official Contact | 8055447511 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Coast Neurology Medical Group, Inc 1035 Peach St Suite 204 San Luis Obispo CA 93401-2700 Ph: (805) 544-7511 | Central Coast Neurology Medical Group, Inc 1035 Peach St Suite 204 San Luis Obispo CA 93401-2700 Ph: (805) 544-7511 |
| NPI Number | 1790199479 |
|---|---|
| Provider Enumeration Date | 06/20/2014 |
| Last Update Date | 06/20/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790199479 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | G04937 (California) | Primary |
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