| Corporation | |
|
1150 Main St Suite 3 Watsonville CA 95076-3747 | |
| (831) 728-0551 | |
| (831) 728-3279 |
| Full Name | Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 1150 Main St, Watsonville, California |
| Authorized Official Name and Position | Jeffrey A Solinas (DIRECTOR) |
| Authorized Official Contact | 8317280551 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Corporation 1150 Main St Suite 3 Watsonville CA 95076-3747 Ph: (831) 728-0551 | Corporation 1150 Main St Suite 3 Watsonville CA 95076-3747 Ph: (831) 728-0551 |
| NPI Number | 1801808357 |
|---|---|
| Provider Enumeration Date | 08/13/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6507934940 |
|---|---|
| Medicare Enrollment ID | O20081013000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801808357 | NPI | - | NPPES |
| 00G431360 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G431360 (California) | Primary |
| Provider Name | Shirley L Dickinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679500565 PECOS PAC ID: 2062307119 Enrollment ID: I20040217001100 |
| Provider Name | Jeffrey Solinas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962498006 PECOS PAC ID: 2062580400 Enrollment ID: I20081013000006 |
| Provider Name | Maria Christa Tamasi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518522994 PECOS PAC ID: 7810223682 Enrollment ID: I20190731003616 |
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