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1301 E Main St Barstow CA 92311-3219 | |
(760) 256-3864 | |
(760) 256-7378 |
Full Name | |
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Speciality | Family Medicine |
Location | 1301 E Main St, Barstow, California |
Authorized Official Name and Position | Michael C Vizcarra (PRESIDENT MEDICAL DIRECTOR) |
Authorized Official Contact | 7609481454 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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11919 Hesperia Rd Suite A Hesperia CA 92345-1855 Ph: (760) 948-1454 | 1301 E Main St Barstow CA 92311-3219 Ph: (760) 256-3864 |
NPI Number | 1508981549 |
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Provider Enumeration Date | 03/20/2007 |
Last Update Date | 08/06/2008 |
Identifier | Type | State | Issuer |
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1508981549 | NPI | - | NPPES |
GR0050901 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | G29952 (California) | Primary |
Windy City Medical Clinic A Professional Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 525 Melissa Ave Ste A, Barstow, CA 92311 Phone: 760-255-2400 Fax: 760-957-7517 | |
Eminence Centers For Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 121 S 7th Ave, Barstow, CA 92311 Phone: 760-581-5600 | |