| Kimen M Colgan, PA | |
|
575 Price St, Suite101, Pismo Beach, CA 93449-2553 | |
| (805) 481-3685 | |
| (805) 481-5245 |
| Full Name | Kimen M Colgan |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 575 Price St, Pismo Beach, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699739227 | NPI | - | NPPES |
| 41929300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 3531 (Arizona) | Primary |
| 363AS0400X | Physician Assistant - Surgical | 1366 (Wisconsin) | Secondary |
| Entity Name | Pcr Oncology Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891139317 PECOS PAC ID: 4082933163 Enrollment ID: O20150512002639 |
| Mailing Address | Practice Location Address |
|---|---|
| Kimen M Colgan, PA 575 Price St, Ste 101, Pismo Beach, CA 93449-2553 Ph: (805) 481-3685 | Kimen M Colgan, PA 575 Price St, Suite101, Pismo Beach, CA 93449-2553 Ph: (805) 481-3685 |
Mr. Craig David Gallagher, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 800 Price Canyon Rd, Pismo Beach, CA 93449 Phone: 805-545-4441 |
Jennifer Lee Gingrich, P.A.-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 877 Oak Park Blvd, Pismo Beach, CA 93449 Phone: 805-474-8450 |
Ms. Stacy D Mierau, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 921 Oak Park Blvd Ste 204, Pismo Beach, CA 93449 Phone: 805-473-4949 Fax: 805-473-3165 |
Cort Darcy Thompson, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 921 Oak Park Blvd Ste 202, Pismo Beach, CA 93449 Phone: 805-473-7818 Fax: 805-473-7820 |
Allyson Marie Holman, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 877 Oak Park Blvd, Pismo Beach, CA 93449 Phone: 805-474-8450 Fax: 805-474-8454 |
Laurie Katherine Moore, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 921 Oak Park Blvd Ste 100a, Pismo Beach, CA 93449 Phone: 805-474-9143 Fax: 805-474-9569 |
Alison Watt, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 931 Oak Park Blvd, Suite 101, Pismo Beach, CA 93449 Phone: 805-474-2600 Fax: 805-474-2607 |