| |
200 S Main St Ste D Templeton CA 93465-9366 | |
(805) 670-2180 | |
(805) 273-0298 |
Full Name | |
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Speciality | Clinic/Center |
Location | 200 S Main St Ste D, Templeton, California |
Authorized Official Name and Position | Elizabeth Claudia Hopkirk Beal (PRESIDENT, MEDICAL DIRECTOR) |
Authorized Official Contact | 5105295825 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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200 S Main St Ste D Templeton CA 93465-9366 Ph: (805) 670-2180 | 200 S Main St Ste D Templeton CA 93465-9366 Ph: (805) 670-2180 |
NPI Number | 1780232850 |
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Provider Enumeration Date | 08/30/2019 |
Last Update Date | 07/20/2021 |
Medicare PECOS PAC ID | 9032530662 |
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Medicare Enrollment ID | O20200605001523 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780232850 | NPI | - | NPPES |
77631 | Other | CA | KAREO EHR |
748145 | Other | CA | ANTHEM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Elizabeth C Beal |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1548540933 PECOS PAC ID: 1850604067 Enrollment ID: I20150716002975 |
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