| |
697 W Tefft St Nipomo CA 93444-9190 | |
(805) 929-2272 | |
(805) 929-6405 |
Full Name | |
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Speciality | Clinic/center - Community Health |
Location | 697 W Tefft St, Nipomo, California |
Authorized Official Name and Position | Matthew Richardson (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 8057393108 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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117 W Bunny Ave Santa Maria CA 93458-2805 Ph: (805) 739-3474 | 697 W Tefft St Nipomo CA 93444-9190 Ph: (805) 929-2272 |
NPI Number | 1508237629 |
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Provider Enumeration Date | 10/15/2015 |
Last Update Date | 11/12/2018 |
Identifier | Type | State | Issuer |
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1508237629 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |