| Arroyo Medical Group, Inc | |
|
931 Oak Park Blvd Suite 101 Pismo Beach CA 93449-3402 | |
| (805) 474-2600 | |
| (805) 474-2607 |
| Full Name | Arroyo Medical Group, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 931 Oak Park Blvd, Pismo Beach, California |
| Authorized Official Name and Position | David Ruiz (COO) |
| Authorized Official Contact | 8054742600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arroyo Medical Group, Inc 931 Oak Park Blvd Suite 101 Pismo Beach CA 93449-3402 Ph: (805) 474-2600 | Arroyo Medical Group, Inc 931 Oak Park Blvd Suite 101 Pismo Beach CA 93449-3402 Ph: (805) 474-2600 |
| NPI Number | 1720093487 |
|---|---|
| Provider Enumeration Date | 07/30/2006 |
| Last Update Date | 04/30/2019 |
| Medicare PECOS PAC ID | 5698723641 |
|---|---|
| Medicare Enrollment ID | O20050106000773 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720093487 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Dewey S Sandberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386654028 PECOS PAC ID: 1052369915 Enrollment ID: I20050106000927 |
| Provider Name | Megan Malzone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518996412 PECOS PAC ID: 5890790422 Enrollment ID: I20061003000424 |
| Provider Name | Amanthi Chandrasena |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790937332 PECOS PAC ID: 0042374522 Enrollment ID: I20090128000197 |
| Provider Name | Cary J Fitchmun |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982614616 PECOS PAC ID: 7911955968 Enrollment ID: I20100726000633 |
| Provider Name | Roger Guthrie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598775215 PECOS PAC ID: 4284682238 Enrollment ID: I20100727000530 |
| Provider Name | David Ruiz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003826884 PECOS PAC ID: 0749238798 Enrollment ID: I20100727000578 |
| Provider Name | Ernest E Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891705661 PECOS PAC ID: 9739137787 Enrollment ID: I20100811000232 |
| Provider Name | Maryam K. Tabrizi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932402476 PECOS PAC ID: 2163679036 Enrollment ID: I20120828000622 |
| Provider Name | Mary A Lowery |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023377637 PECOS PAC ID: 0547418568 Enrollment ID: I20120918000137 |
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