| |
400 Canal St Ste. E King City CA 93930-3461 | |
(831) 385-7200 | |
(831) 385-7278 |
Full Name | |
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Speciality | Clinic/center |
Location | 400 Canal St, King City, California |
Authorized Official Name and Position | Gary Wangsmo (CREDENTIALING) |
Authorized Official Contact | 8313857160 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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300 Canal St King City CA 93930-3431 Ph: (831) 385-6000 | 400 Canal St Ste. E King City CA 93930-3461 Ph: (831) 385-7200 |
NPI Number | 1578792669 |
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Provider Enumeration Date | 07/09/2009 |
Last Update Date | 07/09/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578792669 | NPI | - | NPPES |
ZZZ54849Y | Other | CA | BLUE SHIELD - WOMEN'S CENTER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 070000047 (California) | Primary |
Surf Medical Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 Canal St, King City, CA 93930 Phone: 909-289-1060 | |
M Shehata Iatrocare Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 300 Canal St, King City, CA 93930 Phone: 702-453-3799 Fax: 702-453-5741 | |