NPIMap

Organization Active NPI

Community Health Centers of the Central Coast Inc

Doing business as Community Health Centers Oceano Del Mar

  • Federally Qualified Health Center (FQHC)
  • Oceano, CA
National Provider Identifier
1417480294
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC
Doing business as
Community Health Centers Oceano Del Mar
Practice address
2120 Cienaga
Oceano, CA 93445-9029
Phone
(805) 994-2100
Fax
(805) 994-2197
NPI assigned
Apr 7, 2017
Last updated
Jan 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Authorized official

Name
Barbara Allen
Title
Business Office Manger
Phone
(805) 361-8014

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

2120 Cienaga
Oceano, CA 93445-9029

Mailing address

2050 S Blosser Rd
Santa Maria, CA 93458-7310
Phone (805) 361-8014

Other names 1

  • Community Health Centers Oceano Del Mar Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040115001161 CA Part B Supplier - Clinic/Group Practice 7416868120 Receives reassigned benefits from 236 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Maria, CA; Paso Robles, CA; San Luis Obispo, CA; Templeton, CA; Oceano, CA; Arroyo Grande, CA; Atascadero, CA; Cambria, CA…
O20170912003291 CA Part A Provider - Federally Qualified Health Center (FQHC) 7416868120 Practice locations: Oceano, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417480294. Details of each certification follow.

Federally qualified health center certification: CCN 921012

Legal name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC
Doing business as
CHC DEL MAR
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 1, 2017
Last certification
Aug 1, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 1978 in CA
Enrollment address
2120 Cienaga St
Oceano, CA 93445-9016

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

Other NPIs on the same Medicare enrollment 27

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 27

National Provider Directory

National Provider Directory

Locations

430 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8900

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Sam Orozco Individual Corporate DirectorBoard Member Treasurer May 1, 2015 5%
Bertha Campos Individual Corporate DirectorBoard Member Jul 5, 2017 5%
Ronald E Castle Individual W-2 Managing EmployeeChief Executive Officer Jul 1, 1978 10%
Barbara a Allen Individual W-2 Managing EmployeeBusiness Office Manager Aug 1, 1978 5%
William Gordon Individual Corporate DirectorBoard Member President Jul 5, 2017 5%

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1417480294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8014",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 CIENAGA",
            "city": "OCEANO",
            "state": "CA",
            "postal_code": "934459029",
            "telephone_number": "805-994-2100",
            "fax_number": "805-994-2197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-07",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANGER",
        "authorized_official_telephone_number": "805-361-8014"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Centers Oceano Del Mar",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Health Centers Oceano Del Mar",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oceano, CA

Sources for this page

Verify at the official NPI Registry.