NPIMap

Organization Active NPI

Central Coast Pathology Consultants, Inc

  • Clinical Medical Laboratory
  • San Luis Obispo, CA
National Provider Identifier
1558320143
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
CENTRAL COAST PATHOLOGY CONSULTANTS, INC
Practice address
3701 S Higuera St
Ste. 200
San Luis Obispo, CA 93401-7462
Phone
(805) 541-6033
Fax
(805) 541-6116
NPI assigned
Mar 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2010

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

Authorized official

Name
Mr. Ronald E Rocha, M.D.NPI 1780611533
Title
President/Pathologist
Phone
(805) 541-6033

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

3701 S Higuera St
Ste. 200
San Luis Obispo, CA 93401-7462

Mailing address

PO Box 8139
San Luis Obispo, CA 93403-8139
Phone (805) 549-7461

Other identifiers 2

IdentifierTypeStateIssuer
GR0058760MedicaidCA
LAB43503FMedicaidCA

Other names 1

  • CCPC Clinical Lab Other name

National Provider Directory

National Provider Directory

Locations

102 Santa Rosa St
Sn Luis Obisp, CA 93405
Phone (805) 543-8826

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291852800000",
    "number": "1558320143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8139",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934038139",
            "telephone_number": "805-549-7461",
            "fax_number": "805-549-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 S HIGUERA ST",
            "address_2": "STE. 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017462",
            "telephone_number": "805-541-6033",
            "fax_number": "805-541-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL COAST PATHOLOGY CONSULTANTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2010-12-09",
        "status": "A",
        "authorized_official_last_name": "ROCHA",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT/PATHOLOGIST",
        "authorized_official_telephone_number": "805-541-6033",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0058760",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB43503F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCPC Clinical Lab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; 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.