D E Garrison Do Inc | |
4911 Warner Ave Ste 205 Huntington Beach CA 92649-4473 | |
(661) 387-5211 | |
Not Available |
Full Name | D E Garrison Do Inc |
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Speciality | Family Medicine |
Location | 4911 Warner Ave Ste 205, Huntington Beach, California |
Authorized Official Name and Position | Douglas Garrison (OWNER) |
Authorized Official Contact | 6613875211 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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D E Garrison Do Inc Po Box 35 Sunset Beach CA 90742-0035 Ph: (661) 387-5211 | D E Garrison Do Inc 4911 Warner Ave Ste 205 Huntington Beach CA 92649-4473 Ph: (661) 387-5211 |
NPI Number | 1811517832 |
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Provider Enumeration Date | 04/20/2020 |
Last Update Date | 10/12/2022 |
Medicare PECOS PAC ID | 4981009974 |
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Medicare Enrollment ID | O20221117002633 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811517832 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Secondary |
Provider Name | Douglas E Garrison |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1386649044 PECOS PAC ID: 0941112247 Enrollment ID: I20031104000697 |
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