| Philip Ente Md Inc | |
|
1111 E Ocean Ave Lompoc CA 93436-7076 | |
| (805) 735-7623 | |
| (805) 735-7224 |
| Full Name | Philip Ente Md Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1111 E Ocean Ave, Lompoc, California |
| Authorized Official Name and Position | Philip Ente (OWNER) |
| Authorized Official Contact | 8057357623 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Philip Ente Md Inc 1111 E. Ocean Avenue Lompoc CA 93436 Ph: (805) 735-7623 | Philip Ente Md Inc 1111 E Ocean Ave Lompoc CA 93436-7076 Ph: (805) 735-7623 |
| NPI Number | 1871861500 |
|---|---|
| Provider Enumeration Date | 12/08/2011 |
| Last Update Date | 12/08/2011 |
| Medicare PECOS PAC ID | 7719153253 |
|---|---|
| Medicare Enrollment ID | O20120104000354 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871861500 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | A42029 (California) | Primary |
| Provider Name | Philip Ente |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366474819 PECOS PAC ID: 3375696990 Enrollment ID: I20090729000872 |
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