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4711 Highway 166 New Cuyama CA 93254-0000 | |
(661) 766-2149 | |
(661) 766-2350 |
Full Name | |
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Speciality | Clinic/Center |
Location | 4711 Highway 166, New Cuyama, California |
Authorized Official Name and Position | Barbara Allen (BUSINESS OFFICE MANAGER) |
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 | 4711 Highway 166 New Cuyama CA 93254-0000 Ph: (661) 766-2149 |
NPI Number | 1508105008 |
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Provider Enumeration Date | 02/05/2013 |
Last Update Date | 01/23/2019 |
Medicare PECOS PAC ID | 7416868120 |
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Medicare Enrollment ID | O20180910002736 |
Identifier | Type | State | Issuer |
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1508105008 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |