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217 W Central Ave Ste G Lompoc CA 93436-2830 | |
(805) 733-4292 | |
(805) 735-4293 |
Full Name | |
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Speciality | Clinic/Center |
Location | 217 W Central Ave Ste G, Lompoc, California |
Authorized Official Name and Position | Matthew Richardson (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 8057393108 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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217 W Central Ave Suite G Lompoc CA 93436-2830 Ph: (805) 733-4292 | 217 W Central Ave Ste G Lompoc CA 93436-2830 Ph: (805) 733-4292 |
NPI Number | 1417294455 |
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Provider Enumeration Date | 01/10/2013 |
Last Update Date | 12/11/2024 |
Medicare PECOS PAC ID | 9739091364 |
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Medicare Enrollment ID | O20200217004246 |
Identifier | Type | State | Issuer |
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1417294455 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
Rahim A Raoufi, Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 228 S D St, Suite B, Lompoc, CA 93436 Phone: 208-667-9334 Fax: 208-664-2341 | |
Central Coast Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 119 S B St, Lompoc, CA 93436 Phone: 805-740-9400 Fax: 805-741-2640 | |