NPIMap

Organization Active NPI

Community Heatlh Centers of the Central Coast

Doing business as CHC Pharmacy Atascadero

  • Community Health Clinic/Center
  • Atascadero, CA
National Provider Identifier
1609865864
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
PHY 46797 Issued in CA
Legal business name
COMMUNITY HEATLH CENTERS OF THE CENTRAL COAST
Doing business as
CHC Pharmacy Atascadero
Practice address
5575 Capistrano Ave
Atascadero, CA 93422-4264
Phone
(805) 792-1422
Fax
(805) 792-1488
NPI assigned
Oct 19, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Dr. J Chris Mitsuoka, PHARM.D.
Title
Director of Pharmacy
Phone
(805) 269-1326

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X PHY 46797 CA Primary

Addresses

Primary practice location

5575 Capistrano Ave
Atascadero, CA 93422-4264

Mailing address

150 Tejas PL
Nipomo, CA 93444-9123
Phone (805) 269-1326

Other identifiers 3

IdentifierTypeStateIssuer
PHA467970MedicaidCA
PHY46797OtherCAPHARMACY LICENSE #
5613612OtherCANCPDP NUMBER

Other names 1

  • CHC Pharmacy Atascadero Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Comm HLTH CTRS-Morro Bay22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

5575 Capistrano Ave
Atascadero, CA 93422
Phone (805) 461-6090

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1609865864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 TEJAS PL",
            "city": "NIPOMO",
            "state": "CA",
            "postal_code": "934449123",
            "telephone_number": "805-269-1326",
            "fax_number": "805-269-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 CAPISTRANO AVE",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934224264",
            "telephone_number": "805-792-1422",
            "fax_number": "805-792-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEATLH CENTERS OF THE CENTRAL COAST",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-19",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MITSUOKA",
        "authorized_official_first_name": "J CHRIS",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "805-269-1326",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "PHY 46797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA467970",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE #",
            "identifier": "PHY46797",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "5613612",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHC Pharmacy Atascadero",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atascadero, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.