Organization Name: | CENTRAL COAST PEDIATRICS INC |
NPI Number: | 1083869804 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICHRD J MACIAS (PRES/CFO) |
Mailing Address: | 1320 Las Tablas Rd Suite D Templeton |
State: | CA US |
Postal Code: | 934659711 |
Phone Number: | 8054343796 |
Fax Number: | |
NPI Enumeration Date: | 11/20/2008 |
NPI Last Update Date: | 11/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2080A0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Pediatrics |
Taxonomy Specialization: | Adolescent Medicine |
Taxonomy Definition: | A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |