| Mira Costa Community College District | |
|
1 Barnard Dr Oceanside CA 92056-3899 | |
| (760) 795-6675 | |
| Not Available |
| Full Name | Mira Costa Community College District |
|---|---|
| Speciality | General Practice |
| Location | 1 Barnard Dr, Oceanside, California |
| Authorized Official Name and Position | Kimberly Marquardt (DIRECTOR, HEALTH SERVICES) |
| Authorized Official Contact | 7607956676 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mira Costa Community College District 1 Barnard Dr Oceanside CA 92056-3899 Ph: (760) 795-6675 | Mira Costa Community College District 1 Barnard Dr Oceanside CA 92056-3899 Ph: (760) 795-6675 |
| NPI Number | 1538933262 |
|---|---|
| Provider Enumeration Date | 11/13/2023 |
| Last Update Date | 11/22/2023 |
| Medicare PECOS PAC ID | 7517409360 |
|---|---|
| Medicare Enrollment ID | O20240607000908 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538933262 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Olivia Dalton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427727718 PECOS PAC ID: 2860869641 Enrollment ID: I20221108001681 |
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