Organization · Type 2 NPI

Clinica Familiar Costa Central

Non-Pharmacy Dispensing Site · Watsonville, CA

NPI number 1801938659 Active

Practice location

1185 Freedom Blvd Ste 1
Watsonville, CA 95076-2776

Call (831) 786-9250 Map

Mailing address

5626 Oberlin Dr, Suite 110
San Diego, CA 92121-1705

Specialties and licenses

Taxonomy	Code	License
Non-Pharmacy Dispensing Site Primary	332900000X	A65977 (CA)

Non-Pharmacy Dispensing Site: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

Other non-pharmacy dispensing site providers in Watsonville

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NPI record

NPI: 1801938659
Entity type: Organization (Type 2)
Issued: Feb 12, 2007
Last updated: Oct 17, 2012
Status: Active
Subpart: Yes of Medvantx, Inc.

Other names

<unavail>
Clinica Familiar Costa Central - Ariel Martinez, MD · doing business as

Authorized official

Kenny Heine
Director of Operations
(858) 625-2990

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1801938659

Clinica Familiar Costa Central's National Provider Identifier is 1801938659, issued on Feb 12, 2007. The primary taxonomy on file is Non-Pharmacy Dispensing Site (332900000X), and the practice location is in Watsonville, CA. The record was last updated on Oct 17, 2012.