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1040 W Main St Santa Maria CA 93458-4238 | |
(805) 922-8269 | |
(805) 349-9509 |
Full Name | |
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Speciality | Internal Medicine |
Location | 1040 W Main St, Santa Maria, California |
Authorized Official Name and Position | Michael K Kazak (OWNER) |
Authorized Official Contact | 8059228269 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1040 W Main St Santa Maria CA 93458-4238 Ph: (805) 922-8269 | 1040 W Main St Santa Maria CA 93458-4238 Ph: (805) 922-8269 |
NPI Number | 1528249232 |
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Provider Enumeration Date | 11/21/2007 |
Last Update Date | 12/19/2023 |
Medicare PECOS PAC ID | 9436238128 |
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Medicare Enrollment ID | O20080506000835 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528249232 | NPI | - | NPPES |
W22110 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
Provider Name | Michael K Kazak |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1285732636 PECOS PAC ID: 7810939345 Enrollment ID: I20080416000683 |
Provider Name | Samara M Kazak |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1487230413 PECOS PAC ID: 8921539974 Enrollment ID: I20241002001099 |
Robert S. Barry Md, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1420 S Miller St Ste A, Santa Maria, CA 93454 Phone: 805-922-3033 | |
Nightingale Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1414 S Miller St, Suite 4, Santa Maria, CA 93454 Phone: 805-349-6336 | |