Provider Demographics
NPI:1962495887
Name:CENTRAL COAST PEDIATRIC HEMATOLOGY ONCOLOGY INC.
Entity Type:Organization
Organization Name:CENTRAL COAST PEDIATRIC HEMATOLOGY ONCOLOGY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-569-8394
Mailing Address - Street 1:2329 OAK PARK LN
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4280
Mailing Address - Country:US
Mailing Address - Phone:805-569-8394
Mailing Address - Fax:805-569-8398
Practice Address - Street 1:2329 OAK PARK LN
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4280
Practice Address - Country:US
Practice Address - Phone:805-569-8394
Practice Address - Fax:805-569-8398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-25
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-OncologyGroup - Single Specialty