| Ronald K Shimmin, MD | |
|
1146 San Marino Dr, San Marcos, CA 92078-4649 | |
| (760) 471-2033 | |
| (760) 471-2083 |
| Full Name | Ronald K Shimmin |
|---|---|
| Gender | Male |
| Speciality | General Practice |
| Location | 1146 San Marino Dr, San Marcos, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225153315 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2083X0100X | Preventive Medicine - Occupational Medicine | A37055 (California) | Secondary |
| 208D00000X | General Practice | A37055 (California) | Primary |
| Entity Name | Lake Medical Center, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689863714 PECOS PAC ID: 2567621352 Enrollment ID: O20120314000628 |
| Mailing Address | Practice Location Address |
|---|---|
| Ronald K Shimmin, MD 5080 Spectrum Dr, Suite 1200 West, Addison, TX 75001-4648 Ph: (972) 364-8000 | Ronald K Shimmin, MD 1146 San Marino Dr, San Marcos, CA 92078-4649 Ph: (760) 471-2033 |
Dr. Donald Richmond Bennett, M.D. General Practice Medicare: Accepting Medicare Assignments Practice Location: 310 S Twin Oaks Valley Rd, #107-214, San Marcos, CA 92078 Phone: 760-705-7705 | |
Mr. Manuel Montemayor, MD General Practice Medicare: Not Enrolled in Medicare Practice Location: 727 W San Marcos Blvd, Suite 112, San Marcos, CA 92078 Phone: 760-736-8810 Fax: 760-736-3157 |