| 1150 Main Street Inc | |
|
1150 Main St Ste 3 Watsonville CA 95076-3760 | |
| (831) 728-0551 | |
| (831) 728-3679 |
| Full Name | 1150 Main Street Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1150 Main St Ste 3, Watsonville, California |
| Authorized Official Name and Position | Shirley L Dickinson (MANAGER) |
| Authorized Official Contact | 8317280551 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 1150 Main Street Inc 1150 Main St Ste 3 Watsonville CA 95076-3760 Ph: (831) 728-0551 | 1150 Main Street Inc 1150 Main St Ste 3 Watsonville CA 95076-3760 Ph: (831) 728-0551 |
| NPI Number | 1912347261 |
|---|---|
| Provider Enumeration Date | 07/01/2013 |
| Last Update Date | 07/01/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912347261 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G56281 (California) | Primary |
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