| Palmdale Regional Women's Care, Inc. | |
|
520 W Palmdale Blvd Ste Q Palmdale CA 93551-4229 | |
| (661) 947-3300 | |
| (661) 947-3322 |
| Full Name | Palmdale Regional Women's Care, Inc. |
|---|---|
| Speciality | Obstetrics & Gynecology |
| Location | 520 W Palmdale Blvd, Palmdale, California |
| Authorized Official Name and Position | Ken Clayton (PRESIDENT) |
| Authorized Official Contact | 6619473300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Palmdale Regional Women's Care, Inc. 520 W Palmdale Blvd Ste Q Palmdale CA 93551-4229 Ph: (661) 947-3300 | Palmdale Regional Women's Care, Inc. 520 W Palmdale Blvd Ste Q Palmdale CA 93551-4229 Ph: (661) 947-3300 |
| NPI Number | 1316247182 |
|---|---|
| Provider Enumeration Date | 10/27/2010 |
| Last Update Date | 02/07/2012 |
| Medicare PECOS PAC ID | 0244418259 |
|---|---|
| Medicare Enrollment ID | O20110622000245 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316247182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207V00000X | Obstetrics & Gynecology | (* (Not Available)) | Primary |
| Provider Name | Ken R Clayton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215010194 PECOS PAC ID: 2769449750 Enrollment ID: I20080115000571 |
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