| Cruzmedmo | |
|
626 Frederick St Santa Cruz CA 95062-2203 | |
| (831) 718-0582 | |
| Not Available |
| Full Name | Cruzmedmo |
|---|---|
| Speciality | Clinic/Center |
| Location | 626 Frederick St, Santa Cruz, California |
| Authorized Official Name and Position | Andrew Hamilton Lewis (OWNER) |
| Authorized Official Contact | 8312394331 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cruzmedmo 211 Ladera Ct Santa Cruz CA 95060-5209 Ph: (831) 239-4331 | Cruzmedmo 626 Frederick St Santa Cruz CA 95062-2203 Ph: (831) 718-0582 |
| NPI Number | 1316530132 |
|---|---|
| Provider Enumeration Date | 02/12/2021 |
| Last Update Date | 02/16/2022 |
| Medicare PECOS PAC ID | 7810306883 |
|---|---|
| Medicare Enrollment ID | O20210503002322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316530132 | NPI | - | NPPES |
| Provider Name | Andrew Hamilton Lewis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861432023 PECOS PAC ID: 4880669258 Enrollment ID: I20070907000528 |
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