| |
699 S Main St Ste A Templeton CA 93465-5103 | |
(805) 434-1804 | |
(805) 434-1855 |
Full Name | |
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Speciality | Family Medicine |
Location | 699 S Main St, Templeton, California |
Authorized Official Name and Position | Alexander F Castellanos (PRESIDENT) |
Authorized Official Contact | 8054341804 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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699 S Main St Ste A Templeton CA 93465-5103 Ph: (805) 434-1804 | 699 S Main St Ste A Templeton CA 93465-5103 Ph: (805) 434-1804 |
NPI Number | 1831260520 |
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Provider Enumeration Date | 11/13/2006 |
Last Update Date | 02/05/2020 |
Medicare PECOS PAC ID | 7810078367 |
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Medicare Enrollment ID | O20080122000810 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831260520 | NPI | - | NPPES |
00G373030 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | G37303 (California) | Primary |
Provider Name | Alexander F Castellanos |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1770771511 PECOS PAC ID: 4183705635 Enrollment ID: I20080122000807 |
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