| Coastal Village Primary Care, A Medical Group | |
|
2 James Way Ste 209 Pismo Beach CA 93449-4976 | |
| (805) 773-7440 | |
| (805) 773-7448 |
| Full Name | Coastal Village Primary Care, A Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 2 James Way, Pismo Beach, California |
| Authorized Official Name and Position | Joseph A Cruz (PRESIDENT/MD) |
| Authorized Official Contact | 8057737440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Village Primary Care, A Medical Group Po Box 428 Grover Beach CA 93483-0428 Ph: (805) 773-7440 | Coastal Village Primary Care, A Medical Group 2 James Way Ste 209 Pismo Beach CA 93449-4976 Ph: (805) 773-7440 |
| NPI Number | 1053742528 |
|---|---|
| Provider Enumeration Date | 12/09/2013 |
| Last Update Date | 12/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053742528 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A49080 (California) | Primary |
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Coastal Village Primary, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 James Way, Suite 209, Pismo Beach, CA 93449 Phone: 805-773-7440 Fax: 805-773-7448 | |
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