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1300 W Ocean Ave Lompoc CA 93436-5678 | |
(805) 737-1169 | |
(805) 737-1772 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1300 W Ocean Ave, Lompoc, California |
Authorized Official Name and Position | Barbara Allen (DIRECTOR OF BUSINESS OFFICE) |
Authorized Official Contact | 8053618014 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2050 S Blosser Rd Santa Maria CA 93458-7310 Ph: (805) 361-8014 | 1300 W Ocean Ave Lompoc CA 93436-5678 Ph: (805) 737-1169 |
NPI Number | 1326065103 |
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Provider Enumeration Date | 07/16/2006 |
Last Update Date | 12/12/2023 |
Medicare PECOS PAC ID | 7416868120 |
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Medicare Enrollment ID | O20050804001109 |
Identifier | Type | State | Issuer |
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1326065103 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Rahim A Raoufi, Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 228 S D St, Suite B, Lompoc, CA 93436 Phone: 208-667-9334 Fax: 208-664-2341 | |
Central Coast Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 119 S B St, Lompoc, CA 93436 Phone: 805-740-9400 Fax: 805-741-2640 | |