| Organization Name: | COAST FAMILY PRACTICE |
| NPI Number: | 1811940935 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANDREW J HENNING (OWNER/PHYSICIAN) |
| Mailing Address: | 201 S Miller St Suite 103 Santa Maria |
| State: | CA US |
| Postal Code: | 934545248 |
| Phone Number: | 8059283636 |
| Fax Number: | 8059283608 |
| NPI Enumeration Date: | 05/18/2006 |
| NPI Last Update Date: | 08/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |