Central Coast Neurology Medical Group, Inc

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

License

G04937 Issued in CA

Legal business name

CENTRAL COAST NEUROLOGY MEDICAL GROUP, INC

Practice address

1035 Peach St
Suite 204
San Luis Obispo, CA 93401-2700

Phone

(805) 544-7511

Fax

(805) 544-7560

NPI assigned

Jun 20, 2014

Last updated

Jun 20, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary S Amir, MD

Title

President

Phone

(805) 544-7511

Specialties & licenses 1

Addresses

Tax ID family

Central Coast Neurology Medical Group Inc2 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 Neurology Medical Group, Inc.

  • Neurology Physician
  • San Francisco, CA
  • NPI 1003846403
  NPD tax ID

Practitioners 1

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.

• Mary S. Genevieve, M.D.

  • Neurology Physician
  • San Francisco, CA
  • NPI 1871598706
  NPD

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403222400000",
    "number": "1790199479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 PEACH ST",
            "address_2": "SUITE 204",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012700",
            "telephone_number": "805-544-7511",
            "fax_number": "805-544-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 PEACH ST",
            "address_2": "SUITE 204",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012700",
            "telephone_number": "805-544-7511",
            "fax_number": "805-544-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL COAST NEUROLOGY MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-20",
        "last_updated": "2014-06-20",
        "status": "A",
        "authorized_official_last_name": "AMIR",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-544-7511",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "CA",
            "license": "G04937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Coast Institute for Plastic Surgery, AMC
• Central Coast Lymphedema
• Central Coast Lymphedema Therapy
• Central Coast Maternal-Fetal Medicine
• Central Coast Neurological Surgery PC
• Central Coast Nursing Home Physicians, Inc. (NextGen Concierge Medicine)
• Central Coast Obstetrics & Gynecology, Inc.
• Central Coast Obstetrics & Gynecology, Inc.
• Central Coast Obstetrics and Gynecology, Inc., a Medical Group
• Central Coast Orthopedic Medical Group

• Clinical Neurophysiology Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Clinical Neurophysiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.