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2 James Way Suite 209 Pismo Beach CA 93449-4973 | |
| (805) 739-3474 | |
| (805) 346-3548 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 2 James Way, Pismo Beach, California |
| Authorized Official Name and Position | Matthew Richardson (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 8057393108 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
117 W Bunny Ave Santa Maria CA 93458-2805 Ph: (805) 739-3474 | 2 James Way Suite 209 Pismo Beach CA 93449-4973 Ph: (805) 739-3474 |
| NPI Number | 1538618590 |
|---|---|
| Provider Enumeration Date | 09/30/2016 |
| Last Update Date | 09/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538618590 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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 | |
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 | |
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 | |