Clinica Familiar Costa Central

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

A65977 Issued in CA

Legal business name

CLINICA FAMILIAR COSTA CENTRAL

Practice address

1185 Freedom Blvd Ste 1
Watsonville, CA 95076-2776

Phone

(831) 786-9250

NPI assigned

Feb 12, 2007

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

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

Authorized official

Name

Kenny Heine

Title

Director of Operations

Phone

(858) 625-2990

Specialties & licenses 1

Addresses

Other names 1

• Clinica Familiar Costa Central - Ariel Martinez, MD Doing business as

Part of

Tri - State Medical Group Inc

Practitioners 1

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

• Ariel Martinez, MD

  • Family Medicine Physician
  • Watsonville, CA
  • NPI 1831262880
  NPD (past)

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1801938659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 FREEDOM BLVD STE 1",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950762776",
            "telephone_number": "831-786-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA FAMILIAR COSTA CENTRAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2007-02-12",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "A65977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinica Familiar Costa Central - Ariel Martinez, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carolina Cisneros
• William Clark
• Chloe Clarke
• Patricia Hall Clarke, MD
• Clinica del Valle del Pajaro
• Woodworth B Clum, MD
• Coastal Health Partners
• Coastal Women'S Healthcare
• Elvia Cohen, RN
• Nathan Cohen, MD

• Non-Pharmacy Dispensing Site in Watsonville, CA
• Providers in Watsonville, CA by specialty
• Non-Pharmacy Dispensing Site in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.