Central Coast Otolaryngology

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

PA13405 Issued in CA

Legal business name

CENTRAL COAST OTOLARYNGOLOGY

Practice address

116 S Palisade Dr Ste 206
Santa Maria, CA 93454-8906

Phone

(805) 614-9250

NPI assigned

Jun 9, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Richard Wikholm, M.D.NPI 1831198647

Title

Owner and Physician

Phone

(805) 614-9250

Specialties & licenses 1

Addresses

Tax ID family

Central Coast Otolaryngology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Central Coast Otolaryngology

  • Otolaryngology Physician
  • Santa Maria, CA
  • NPI 1427382811
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard P Wikholm, MD

  • Otolaryngology Physician
  • Santa Maria, CA
  • NPI 1831198647
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402272000000",
    "number": "1043623960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 S PALISADE DR STE 206",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934548906",
            "telephone_number": "805-614-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S PALISADE DR STE 206",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934548906",
            "telephone_number": "805-614-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL COAST OTOLARYNGOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-09",
        "last_updated": "2014-06-09",
        "status": "A",
        "authorized_official_last_name": "WIKHOLM",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER AND PHYSICIAN",
        "authorized_official_telephone_number": "805-614-9250",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "PA13405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Coast Medical Oncology Corp
• Central Coast Medical Oncology Corp
• Central Coast Nursing Home Physicians, Inc.
• Central Coast Obstetrics and Gynecology
• Central Coast Orthopedic Medical Group
• Central Coast Otolaryngology
• Central Coast Portable Imaging Inc
• Central Coast Treatment Centers
• Central Coast Trstment Center
• Central Coast Urgent Care Medical Group

• Medical Specialty Clinic/Center in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.