| Coastal Village Primary Care | |
|
2 James Way Suite 209 Pismo Beach CA 93449-4976 | |
| (805) 773-7440 | |
| (805) 773-7448 |
| Full Name | Coastal Village Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 2 James Way, Pismo Beach, California |
| Authorized Official Name and Position | Joseph A. Cruz (GENERAL PARTNER) |
| Authorized Official Contact | 8057737440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Village Primary Care Po Box 428 Grover Beach CA 93483-0428 Ph: (805) 773-7440 | Coastal Village Primary Care 2 James Way Suite 209 Pismo Beach CA 93449-4976 Ph: (805) 773-7440 |
| NPI Number | 1992738496 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 09/16/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992738496 | NPI | - | NPPES |
| ZZZ06670Z | Other | CA | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A49080 (California) | Primary |
| 207R00000X | Internal Medicine | A70251 (California) | Secondary |
Coastal Village Primary Care, A Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 James Way, Ste 209, Pismo Beach, CA 93449 Phone: 805-773-7440 Fax: 805-773-7448 | |
Ventana Health And Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 Oak Park Blvd, Suite 101, Pismo Beach, CA 93449 Phone: 805-489-2205 | |
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 | |
Pismo Family Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 575 Price St, Suite 101, Pismo Beach, CA 93449 Phone: 805-773-0707 Fax: 805-773-2051 | |
Hinds Medical Group A Professional Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 220 Princessa Ln, Pismo Beach, CA 93449 Phone: 805-704-2835 Fax: 052-213-2998 | |
Pismo Beach Pediatric Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 James Way, Suite 209, Pismo Beach, CA 93449 Phone: 805-739-3474 Fax: 805-346-3548 | |
Ventana Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 Oak Park Blvd Ste 101, Pismo Beach, CA 93449 Phone: 805-730-3981 |