| Richard P Wikholm, MD | |
|
116 S Palisade Dr, Ste 206, Santa Maria, CA 93454-8904 | |
| (805) 614-9250 | |
| (805) 614-9260 |
| Full Name | Richard P Wikholm |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology |
| Experience | 41 Years |
| Location | 116 S Palisade Dr, Santa Maria, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831198647 | NPI | - | NPPES |
| 00G558110 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | G55811 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Marian Regional Medical Center | Santa maria, CA | Hospital |
| French Hospital Medical Center | San luis obispo, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Central Coast Otolaryngology | 2769521178 | 3 |
| Entity Name | Central Coast Otolaryngology |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427382811 PECOS PAC ID: 2769521178 Enrollment ID: O20091124000624 |
| Mailing Address | Practice Location Address |
|---|---|
| Richard P Wikholm, MD Po Box 5427, Santa Maria, CA 93456-5427 Ph: (805) 614-6250 | Richard P Wikholm, MD 116 S Palisade Dr, Ste 206, Santa Maria, CA 93454-8904 Ph: (805) 614-9250 |
Dr. Raymund J Llaurado, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 220 S Palisade Dr, Suite 102, Santa Maria, CA 93454 Phone: 805-922-6641 Fax: 805-922-5927 | |
Matthew Jon Lelegren, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 206 S Stratford Ave Ste A, Santa Maria, CA 93454 Phone: 805-928-5767 Fax: 805-349-0222 | |
Garabed Messrobain, MD Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 116 S Palisade Dr, Ste 206, Santa Maria, CA 93454 Phone: 805-347-9992 Fax: 805-614-9260 |