Provider Demographics
NPI:1568027043
Name:CENTRAL COAST CARDIOVASCULAR GROUP INC
Entity Type:Organization
Organization Name:CENTRAL COAST CARDIOVASCULAR GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AUBREY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAUB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-967-0497
Mailing Address - Street 1:2937 LOMA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2915
Mailing Address - Country:US
Mailing Address - Phone:805-648-2763
Mailing Address - Fax:
Practice Address - Street 1:334 S PATTERSON AVE STE 208
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2400
Practice Address - Country:US
Practice Address - Phone:805-967-0497
Practice Address - Fax:805-638-0322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty