| Santa Cruz Personal Physicians Inc | |
|
634 Frederick St Santa Cruz CA 95062 | |
| (831) 421-9535 | |
| (831) 421-9290 |
| Full Name | Santa Cruz Personal Physicians Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 634 Frederick St, Santa Cruz, California |
| Authorized Official Name and Position | Mercedes Grace Laurencin (CEO) |
| Authorized Official Contact | 8314219535 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Santa Cruz Personal Physicians Inc 634 Frederick St Santa Cruz CA 95062 Ph: (831) 421-9535 | Santa Cruz Personal Physicians Inc 634 Frederick St Santa Cruz CA 95062 Ph: (831) 421-9535 |
| NPI Number | 1205933496 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 04/13/2018 |
| Medicare PECOS PAC ID | 1759320062 |
|---|---|
| Medicare Enrollment ID | O20050426001503 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205933496 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G51038 (California) | Primary |
| Provider Name | Mercedes G Laurencin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750401055 PECOS PAC ID: 2769438985 Enrollment ID: I20050330000620 |
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