| Organization Name: | CENTRAL COAST MOBILITY |
| NPI Number: | 1730411828 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALI TATREAU (MANAGER) |
| Mailing Address: | 358 Quintana Rd Morro Bay |
| State: | CA US |
| Postal Code: | 934422054 |
| Phone Number: | 8057728210 |
| Fax Number: | |
| NPI Enumeration Date: | 02/01/2010 |
| NPI Last Update Date: | 02/01/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | 097336 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |