CENTRAL COAST CARDIOTHORACIC SURGICAL ASSOCIATES-A MEDICAL GROUP (NPI# 1871527838) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871527838 |
| Entity Type | Organization |
| Organization Name | CENTRAL COAST CARDIOTHORACIC SURGICAL ASSOCIATES-A MEDICAL GROUP |
| Practice Address |
911 Oak Park Blvd Ste 102 Pismo Beach CA 93449-3405 |
| Practice Telephone | 8055566001 |
| Practice Fax Number | 8057734232 |
| Mailing Telephone | 8055566001 |
| Mailing Fax Number | 8057734232 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2017-03-01 |
| Authorized Official Name | MS. LISA M KENT (OFFICE MANAGER) |
| Authorized Official Telephone | 8055566001 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0071980 | 05 |
| Street Address |
911 OAK PARK BLVD STE 102 |
| City | PISMO BEACH |
| State | CA |
| Zip Code | 93449-3405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275538605 | Amy E. Webb | Pediatrics | 911 Oak Park Blvd, Suite 107, Pismo Beach, CA 93449-3405 | 2005-06-13 |
| 1497133011 | Ken P Optometry Corp | Optometrist | 911 Oak Park Blvd, Suite 104, Pismo Beach, CA 93449-3405 | 2015-05-14 |
| 1851631097 | Model Drug Inc | Pharmacy | 911 Oak Park Blvd, Suite 101, Pismo Beach, CA 93449-3405 | 2013-02-26 |
| 1427351535 | Brian O'carroll, D.p.m., Inc. | Podiatrist | 911 Oak Park Blvd, Ste 106, Pismo Beach, CA 93449-3406 | 2010-12-10 |
| 1558663690 | Steve Clark Dpm Inc | Podiatrist | 911 Oak Park Blvd, Ste 106, Pismo Beach, CA 93449-3406 | 2010-11-22 |
| 1679654719 | Health Quest Pharmacy Inc | Pharmacy | 911 Oak Park Blvd, #101, Pismo Beach, CA 93449 | 2006-10-17 |
| 1114952462 | Steven Jon Clark | Podiatrist | 911 Oak Park Blvd, Ste 106, Pismo Beach, CA 93449-3406 | 2006-07-12 |
| 1336133768 | Brian David O'carroll | Podiatrist | 911 Oak Park Blvd, Ste 106, Pismo Beach, CA 93449-3406 | 2005-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831688795 | Kristyn Collins | Psychologist | 130 James Way, #150, Pismo Beach, CA 93449 | 2018-05-07 |
| 1245750140 | Judy Burke Morabito | Pedorthist | 801 Dolliver Street, Pismo Beach, CA 93449 | 2017-06-21 |
| 1295274413 | The San Luis Obispo Hearing Center, Inc | Specialist | 901 Oak Park Blvd Suite 202, Pismo Beach, CA 93449 | 2017-02-21 |
| 1649713645 | Sarah Victoria Stroemel | Counselor | 172 Stimson Ave, #3, Pismo Beach, CA 93449 | 2016-11-22 |
| 1497133631 | Byron N Collier | Podiatrist | 911 Oak Park Blvd Ste 106, Pismo Beach, CA 93449 | 2015-05-07 |
| 1982973319 | Mariana Dintyala | Nurse Practitioner | Avery Healthcare Sevices, 230 Coral Ct, Pismo Beach, CA 93449 | 2011-12-13 |
| 1538444575 | Chelsea Hunter | Student in an Organized Health Care Education/Training Program | 448 Foothill Rd, Pismo Beach, CA 93449 | 2011-10-20 |
| 1952621492 | Briana Leigh Schiro | Counselor | 314 El Portal Dr., Suite 100, Pismo Beach, CA 93449 | 2010-06-07 |
| 1134365315 | Robert Lee Hix | Licensed Psychiatric Technician | 201 Five Cities Dr., 123, Pismo Beach, CA 93449 | 2008-12-18 |
| 1689886764 | Active Physical Therapy Inc | Physical Therapist | 1851 Shell Beach Rd, Suite B, Shell Beach, CA 93449 | 2007-05-03 |
| Find all providers in zip 93449 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306959119 | James Robert Skow | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 310 James Way, Suite 250, Pismo Beach, CA 93449-2876 | 2006-08-16 |
| 1982711289 | David Alan Canvasser | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 310 James Way, Suite 250, Pismo Beach, CA 93449-2876 | 2006-08-23 |
| 1942317268 | Luke Arthur Faber | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 310 James Way, Suite 250, Pismo Beach, CA 93449-2876 | 2006-08-23 |
| 1710094024 | Stephen Joseph Freyaldenhoven | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 310 James Way, Suite 250, Pismo Beach, CA 93449-2876 | 2006-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598370728 | North County Cvt Surgery Associates | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3156 Vista Way Ste 100, Oceanside, CA 92056-3694 | 2020-09-14 |
| 1417560756 | Valiana Vascular Institute Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2501 E Chapman Ave Ste 220, Fullerton, CA 92831-3108 | 2020-08-26 |
| 1891252474 | Miguel Puig Md A Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1430 Esplanade Ste 10, Chico, CA 95926-3366 | 2019-03-01 |
| 1598247991 | Pavel V Petrik Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1331 W Avenue J Ste 203, Lancaster, CA 93534-2954 | 2018-08-31 |
| 1942797378 | Sharon A Bogerty Md Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 105 N Bascom Ave Ste 101b, San Jose, CA 95128-1811 | 2018-04-20 |
| 1992231112 | Samer Kanaan Md A Professional Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 27451 Los Altos, Suite 290, Mission Viejo, CA 92691 | 2017-05-08 |
| 1073065512 | Central California Chest Surgery | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 729 N Medical Center Dr W Ste 223, Clovis, CA 93611-6885 | 2016-11-01 |
| 1407214612 | George Arnold Mulder | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1150 Laurel St, Pasadena, CA 91103-2329 | 2016-02-02 |
| 1760849905 | Steven R Gundry Md Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 555 E Tachevah Dr Ste 3w103, Palm Springs, CA 92262-5747 | 2016-01-19 |
| 1386018687 | Riyad Youssef Tarazi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 9120 Judicial Dr, Apt 7522, San Diego, CA 92122-6700 | 2015-11-24 |
| Find all providers with the same taxonomy | ||||
| City | PISMO BEACH |
| Zip Code | 93449 |
Please comment or provide details below to improve the information on CENTRAL COAST CARDIOTHORACIC SURGICAL ASSOCIATES-A MEDICAL GROUP.
| 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.