Provider Demographics
NPI:1477571370
Name:ARTHRITIS MEDICAL CENTER OF THE CENTRAL COAST A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ARTHRITIS MEDICAL CENTER OF THE CENTRAL COAST A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:805-473-4001
Mailing Address - Street 1:860 OAK PARK BLVD
Mailing Address - Street 2:STE 204
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-1800
Mailing Address - Country:US
Mailing Address - Phone:805-473-4001
Mailing Address - Fax:714-590-6489
Practice Address - Street 1:860 OAK PARK BLVD
Practice Address - Street 2:STE 204
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-1800
Practice Address - Country:US
Practice Address - Phone:805-473-4001
Practice Address - Fax:714-590-6489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7253207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty