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1560 Mesa Rd, Ste 100 Nipomo CA 93444 | |
(805) 739-3981 | |
(805) 739-3981 |
Full Name | |
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Speciality | Clinic/center - Community Health |
Location | 1560 Mesa Rd, Ste 100, 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) 739-3890 | 1560 Mesa Rd, Ste 100 Nipomo CA 93444 Ph: (805) 739-3981 |
NPI Number | 1417555061 |
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Provider Enumeration Date | 10/15/2020 |
Last Update Date | 05/06/2021 |
Identifier | Type | State | Issuer |
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1417555061 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |