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13646 Highway 33 Lost Hills CA 93249-9719 | |
(661) 797-6606 | |
(661) 797-6667 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 13646 Highway 33, Lost Hills, California |
Authorized Official Name and Position | Larry Wolk (CHIEF MEDICAL OFFICER) |
Authorized Official Contact | 6617202660 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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13646 Highway 33 Lost Hills CA 93249-9719 Ph: (661) 797-6606 | 13646 Highway 33 Lost Hills CA 93249-9719 Ph: (661) 797-6606 |
NPI Number | 1750752804 |
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Provider Enumeration Date | 10/15/2015 |
Last Update Date | 09/03/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750752804 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | C140498 (California) | Primary |
Wonderful Center For Health Innovation Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14848 Lamberson Ave, Lost Hills, CA 93249 Phone: 661-720-2660 Fax: 661-720-2661 | |