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3596 Skyway Dr Ste B Santa Maria CA 93455-2514 | |
(805) 614-7820 | |
Not Available |
Full Name | |
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Speciality | General Practice |
Location | 3596 Skyway Dr Ste B, Santa Maria, California |
Authorized Official Name and Position | Matthew Egbert (CEO) |
Authorized Official Contact | 8056147820 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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3596 Skyway Dr Ste B Santa Maria CA 93455-2514 Ph: (805) 614-7820 | 3596 Skyway Dr Ste B Santa Maria CA 93455-2514 Ph: (805) 614-7820 |
NPI Number | 1053872713 |
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Provider Enumeration Date | 03/26/2019 |
Last Update Date | 09/12/2023 |
Medicare PECOS PAC ID | 1355678905 |
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Medicare Enrollment ID | O20200410000178 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053872713 | NPI | - | NPPES |
1205806874 | Other | CA | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Robert S. Barry Md, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1420 S Miller St Ste A, Santa Maria, CA 93454 Phone: 805-922-3033 | |
Nightingale Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1414 S Miller St, Suite 4, Santa Maria, CA 93454 Phone: 805-349-6336 | |