Provider Demographics
NPI:1033418736
Name:CENTRAL COAST ASSOCIATED PHYSICIANS, INC.
Entity Type:Organization
Organization Name:CENTRAL COAST ASSOCIATED PHYSICIANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE INCORPORATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-428-6812
Mailing Address - Street 1:PO BOX 748133
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-8133
Mailing Address - Country:US
Mailing Address - Phone:805-434-4315
Mailing Address - Fax:805-434-4314
Practice Address - Street 1:1220 LAS TABLAS RD
Practice Address - Street 2:SUITE 1418
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465
Practice Address - Country:US
Practice Address - Phone:805-434-4315
Practice Address - Fax:805-434-4314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-21
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty