CENTRAL COAST FACIAL SURGERY CENTER (NPI# 1083671358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083671358 |
| Entity Type | Organization |
| Organization Name | CENTRAL COAST FACIAL SURGERY CENTER |
| Practice Address |
295 Posada Ln Suite B Templeton CA 93465-4055 |
| Practice Telephone | 8054345960 |
| Practice Fax Number | 8054345963 |
| Mailing Telephone | 8054345960 |
| Mailing Fax Number | 8054345963 |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2007-08-21 |
| Authorized Official Name | DR. ROMAN P BUKACHEVSKY (MEMBER-MANAGER) |
| Authorized Official Telephone | 8054345960 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
FNP26330 | CA | Ambulatory Health Care Facilities |
| Street Address |
295 POSADA LN SUITE B |
| City | TEMPLETON |
| State | CA |
| Zip Code | 93465-4055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205836954 | Roman Platon Bukachevsky | Otolaryngology | 295 Posada Ln, Suite B, Templeton, CA 93465-4055 | 2005-07-22 |
| 1447471883 | Libby A Kerr | Registered Nurse | 295 Posada Ln, Suite C, Templeton, CA 93465-4055 | 2007-05-02 |
| 1528195625 | Roman P. Bukachevsky, Md, Inc | Specialist | 295 Posada Ln, Suite B, Templeton, CA 93465-4055 | 2007-02-27 |
| 1013085810 | Andrew S Dennish | Internal Medicine | 295 Posada Ln, Suite A, Templeton, CA 93465 | 2006-12-01 |
| 1023109048 | Lawrence E Vondollen | Internal Medicine | 295 Posada Ln, Ste A, Templeton, CA 93465-4055 | 2006-09-27 |
| 1104805837 | Michael L Wiechmann | Internal Medicine | 295 Posada Ln, Ste A, Templeton, CA 93465 | 2006-01-11 |
| 1821081043 | Steven Jerome Mcallen | Internal Medicine | 295 Posada Ln, Suite C, Templeton, CA 93465-4055 | 2005-08-23 |
| 1013909811 | Shannon M Berry | Internal Medicine | 295 Posada Ln, Suite D, Templeton, CA 93465-4055 | 2005-08-17 |
| 1790777506 | Julie C Fallon | Internal Medicine | 295 Posada Ln, Suite D, Templeton, CA 93465-4055 | 2005-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346773306 | Edward Delos Trino | Nurse Practitioner | 350 Posada Ln # 102, Templeton, CA 93465 | 2017-04-06 |
| 1497102883 | Miriam Castillo | Counselor | 44 Brewer St, Templeton, CA 93465 | 2016-05-16 |
| 1013395821 | Marna Moore-barr | Registered Nurse | 90 Dandelion Ln, Templeton, CA 93465 | 2015-05-12 |
| 1396007308 | Melissa Lee Gaidis | Psychologist | 225 Posada Lane, Suite L, Templeton, CA 93465 | 2012-06-14 |
| 1033418736 | Central Coast Associated Physicians, Inc. | Internal Medicine | 1220 Las Tablas Rd, Suite 1418, Templeton, CA 93465 | 2011-03-21 |
| 1922306281 | Benjamin Ernest Bartel | Counselor | 1827 Orlen Lane, Templeton, CA 93465 | 2011-03-09 |
| 1003116674 | Tiffney Taylor | Internal Medicine | 265 Posada Ln Ste B, Templeton, CA 93465 | 2010-10-28 |
| 1124355342 | Mary Christine Schaff | Nurse Practitioner | 1111 Las Tablas Rd., Ste. M, Templeton, CA 93465 | 2009-11-09 |
| 1417196890 | Liberty Michael Romig | Marriage & Family Therapist | 318 Crocker Street, Templeton, CA 93465 | 2009-02-09 |
| 1427212273 | Linda Kay Shaleen | Social Worker | 212 Main Street Suite 201, Templeton, CA 93465 | 2008-07-10 |
| Find all providers in zip 93465 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841396850 | Physicians Healthcare Partners, Inc. | Clinic/Center | 1101 Las Tablas Rd Ste K, Templeton, CA 93465-5604 | 2006-09-16 |
| 1942239751 | Posada Ambulatory Surgery Center, Lp | Clinic/Center | 322 Posada Ln Ste B, Templeton, CA 93465-4003 | 2006-07-02 |
| 1063453561 | Templeton Surgery Center, LLC | Clinic/Center | 1310 Las Tablas Road, Suite 104, Templeton, CA 93465-9746 | 2006-06-08 |
| 1205009040 | North County Associates, LLC | Clinic/Center | 1105 Las Tablas Rd, Suite #e, Templeton, CA 93465-9731 | 2008-04-11 |
| 1639274723 | Anthony W. Sheplay, Md, Dba: Templeton Surgery Center | Clinic/Center | 1105 Las Tablas Rd, Suite E, Templeton, CA 93465-9731 | 2006-09-13 |
| 1477562148 | Sani Eye Center, Inc. | Clinic/Center | 1315 Las Tablas Rd, Templeton, CA 93465-9759 | 2006-08-05 |
| 1184699241 | San Luis Obispo Ca Endoscopy Asc Lp | Clinic/Center | 1320 Las Tablas Rd, Suite A, Templeton, CA 93465-9711 | 2006-02-22 |
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| 1790384303 | Abroms Dougherty Vision Asc LLC | Clinic/Center | 4472 Broad St Ste 150, San Luis Obispo, CA 93401-7933 | 2020-10-23 |
| 1861091993 | Willow Vista Surgical Center | Clinic/Center | 39810 Portola Ave, Palm Desert, CA 92260-0624 | 2020-10-20 |
| 1366041469 | The Regents of The University of California | Clinic/Center | 4343 Lankershim Blvd Ste 210, North Hollywood, CA 91602-2705 | 2020-10-20 |
| 1609473420 | Alden Advanced Surgicenter LLC | Clinic/Center | 8741 Alden Drive, Suite B, Los Angeles, CA 90048 | 2020-10-05 |
| 1396352944 | Irvine Surgical Center LLC | Clinic/Center | 17624 Redhill Ave Ste B, Irvine, CA 92614 | 2020-09-28 |
| 1538775267 | Ev Surgery Institute LLC | Clinic/Center | 105 N Bascom Ave Ste 105, San Jose, CA 95128-1811 | 2020-09-18 |
| 1003420001 | On Beach Surgery Center, LLC | Clinic/Center | 5832 Beach Blvd, Suite 210, Buena Park, CA 90621 | 2020-09-07 |
| 1811501661 | Precision Surgical Arts | Clinic/Center | 20311 Sw Birch St Ste 201, Newport Beach, CA 92660-1777 | 2020-08-31 |
| 1205448750 | Elite Surgery Center of South Bay LLC | Clinic/Center | 20528 Hawthorne Blvd Ste 301, Torrance, CA 90503-3202 | 2020-08-17 |
| 1740891571 | Peninsula Surgery Center, LLC | Clinic/Center | 350 Marine Pkwy Ste 100, Redwood City, CA 94065-5224 | 2020-08-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.