| Hybrid Md | |
|
1031 Avenida Pico Sutie 103 San Clemente CA 92673-6352 | |
| (202) 904-8490 | |
| Not Available |
| Full Name | Hybrid Md |
|---|---|
| Speciality | Family Medicine |
| Location | 1031 Avenida Pico, San Clemente, California |
| Authorized Official Name and Position | Colin Xephary Jairam (PRESIDENT) |
| Authorized Official Contact | 9494291919 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hybrid Md 1031 Avenida Pico Sutie 103 San Clemente CA 92673-6352 Ph: (949) 429-1919 | Hybrid Md 1031 Avenida Pico Sutie 103 San Clemente CA 92673-6352 Ph: (202) 904-8490 |
| NPI Number | 1093126609 |
|---|---|
| Provider Enumeration Date | 05/16/2014 |
| Last Update Date | 01/10/2017 |
| Medicare PECOS PAC ID | 2567681786 |
|---|---|
| Medicare Enrollment ID | O20140919000801 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093126609 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A101534 (California) | Primary |
| Provider Name | Colin X Jairam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821272295 PECOS PAC ID: 7810052719 Enrollment ID: I20090209000683 |
| Provider Name | Dorcas M Eaves |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962463901 PECOS PAC ID: 2769640374 Enrollment ID: I20120228000153 |
| Provider Name | Kahesha K Franklin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033493424 PECOS PAC ID: 0840454948 Enrollment ID: I20160415000577 |
| Provider Name | Lauren Palmer Deats |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619447562 PECOS PAC ID: 6103150495 Enrollment ID: I20190619003518 |
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Active Life Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 380 Camino De Estrella, San Clemente, CA 92672 Phone: 949-487-1231 | |
California Rehabilitation & Sports Therapy A California Physical Ther Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 415 E Avenida Pico, San Clemente, CA 92672 Phone: 949-245-6581 Fax: 949-688-2136 | |
Inchel Yeam Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 675 Camino De Los Mares Ste 200, San Clemente, CA 92673 Phone: 949-489-8783 | |
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