Eastside Neighborhood Clinic | |
915 N Milpas St Santa Barbara CA 93103-2331 | |
(805) 963-1641 | |
(805) 962-6616 |
Full Name | Eastside Neighborhood Clinic |
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Speciality | Clinic/Center |
Location | 915 N Milpas St, Santa Barbara, California |
Authorized Official Name and Position | Charles Camillo Fenzi (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 8056177850 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Eastside Neighborhood Clinic 915 N Milpas St 2nd Floor Santa Barbara CA 93103-2331 Ph: (805) 617-7858 | Eastside Neighborhood Clinic 915 N Milpas St Santa Barbara CA 93103-2331 Ph: (805) 963-1641 |
NPI Number | 1063438232 |
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Provider Enumeration Date | 07/14/2006 |
Last Update Date | 03/03/2016 |
Medicare PECOS PAC ID | 3870550247 |
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Medicare Enrollment ID | O20110915000763 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063438232 | NPI | - | NPPES |
050000113 | Other | CA | COMMUNITY CLINIC LICENSE |
HAP70114G | Other | CA | FAMPACT LEGACY NUMBER |
BCP70114G | Other | CA | CDP PROVIDER NUMBER |
EAP70114G | Other | CA | EAPC PROVIDER NUMBER |
CLP 303897 | Other | CA | DHS LAB REGISTRATION NUMBER |
168904 | Other | CA | CCS |
05D0584453 | Other | CA | CLIA NUMBER |
CLN 1072 | Other | CA | BOARD OF PHARMACY CLINIC PERMIT |
FHC70114G | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 050000113 (California) | Primary |
Allen J Thomashefsky, Md, A Professional Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2320 Bath St Ste 301, Santa Barbara, CA 93105 Phone: 805-962-2662 Fax: 805-569-5670 | |
Recovery Road Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1602 State Street, Santa Barbara, CA 93101 Phone: 805-962-7800 Fax: 805-962-9002 | |
Milpas Medical Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 816 N Milpas St, Santa Barbara, CA 93103 Phone: 805-965-8284 Fax: 805-962-0429 | |
Jeffrey R. Polito M.d. A Professional Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 334 S Patterson Ave, Santa Barbara, CA 93111 Phone: 805-681-1490 Fax: 805-681-1593 | |
Gary M Van Deventer Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 221 W Pueblo St, Suite B, Santa Barbara, CA 93105 Phone: 805-563-0024 Fax: 805-563-1454 | |
Deleys Brandman Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2830 Glendessary Ln, Santa Barbara, CA 93105 Phone: 415-819-3138 |