Provider Demographics
NPI:1427372226
Name:CENTRAL COAST URGENT CARE INC
Entity Type:Organization
Organization Name:CENTRAL COAST URGENT CARE INC
Other - Org Name:URGENT CARE OF MORRO BAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:N
Authorized Official - Last Name:SORENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:805-771-0108
Mailing Address - Street 1:PO BOX 727
Mailing Address - Street 2:
Mailing Address - City:MORRO BAY
Mailing Address - State:CA
Mailing Address - Zip Code:93443-0727
Mailing Address - Country:US
Mailing Address - Phone:805-771-0108
Mailing Address - Fax:805-771-0111
Practice Address - Street 1:783 QUINTANA RD
Practice Address - Street 2:
Practice Address - City:MORRO BAY
Practice Address - State:CA
Practice Address - Zip Code:93442-1966
Practice Address - Country:US
Practice Address - Phone:805-771-0108
Practice Address - Fax:805-771-0111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-23
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34991261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA34991OtherMEDICAL BOARD OF CALIFORNIA