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5920 West Mall Atascadero CA 93422 | |
(805) 739-3890 | |
(805) 347-7697 |
Full Name | |
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Speciality | Clinic/Center |
Location | 5920 West Mall, Atascadero, California |
Authorized Official Name and Position | Matthew Richardson (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 8057393108 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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117 W Bunny Ave Santa Maria CA 93458-2805 Ph: (805) 739-3474 | 5920 West Mall Atascadero CA 93422 Ph: (805) 739-3890 |
NPI Number | 1932598521 |
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Provider Enumeration Date | 01/20/2015 |
Last Update Date | 11/12/2018 |
Medicare PECOS PAC ID | 9739091364 |
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Medicare Enrollment ID | O20190416001316 |
Identifier | Type | State | Issuer |
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1932598521 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
Trinity Healthcare Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5855 Capistrano Ave, Suite D, Atascadero, CA 93422 Phone: 805-446-5600 Fax: 805-446-5601 | |
Brisco Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6907 El Camino Real Ste A, Atascadero, CA 93422 Phone: 805-550-8880 | |
Nationwide Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6500 Morro Rd Ste D, Atascadero, CA 93422 Phone: 805-461-5212 Fax: 805-461-5873 | |
County Of San Luis Obispo Drug And Alcohol Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3556 El Camino Real, Atascadero, CA 93422 Phone: 805-461-6080 Fax: 805-461-6114 |