NPIMap

Organization Active NPI

Pacific Central Coast Health Centers

Doing business as Nipomo Health Center

  • Community Health Clinic/Center
  • Nipomo, CA
National Provider Identifier
1508237629
Registry record updated Nov 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
PACIFIC CENTRAL COAST HEALTH CENTERS
Doing business as
Nipomo Health Center
Practice address
697 W Tefft St
Nipomo, CA 93444-9190
Phone
(805) 929-2272
Fax
(805) 929-6405
NPI assigned
Oct 15, 2015
Last updated
Nov 16, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
PACIFIC CENTRAL COAST HEALTH CENTERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 16, 2025

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

Authorized official

Name
Brandon Merlo
Title
Chief Financial Officer
Phone
(805) 739-3853

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X NU Primary

Addresses

Primary practice location

697 W Tefft St
Nipomo, CA 93444-9190

Mailing address

1414 E Main St Ste 201
Santa Maria, CA 93454-4890
Phone (805) 994-5485

Other names 1

  • Nipomo Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031103000443 CA Part B Supplier - Clinic/Group Practice 9739091364 Receives reassigned benefits from 305 practitioners
This NPI is an additional NPI on the enrollment

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2107198Nipomo Health Center697 W Tefft St, Nipomo, CA 93444Certificate of waiverJan 31, 2027

National Provider Directory

National Provider Directory
Tax ID family
Pacific Central Coast Health Centers37 organizations share this tax ID, including this one
Part of
Pacific Central Coast Health Centers

Other organizations with this tax ID 36

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

View all 36

Locations

1560 Mesa Rd
Ste 100
Nipomo, CA 93444
Phone (805) 614-5640

Practitioners & affiliated clinicians

Practitioners 6

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": "1444867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763251200000",
    "number": "1508237629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 E MAIN ST STE 201",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934544890",
            "telephone_number": "805-994-5485",
            "fax_number": "805-614-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "697 W TEFFT ST",
            "city": "NIPOMO",
            "state": "CA",
            "postal_code": "934449190",
            "telephone_number": "805-929-2272",
            "fax_number": "805-929-6405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CENTRAL COAST HEALTH CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PACIFIC CENTRAL COAST HEALTH CENTERS",
        "enumeration_date": "2015-10-15",
        "last_updated": "2025-11-16",
        "certification_date": "2025-11-16",
        "status": "A",
        "authorized_official_last_name": "MERLO",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "805-739-3853"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nipomo Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nipomo Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nipomo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.