| Lake San Marcos Family Medicine | |
|
1030 La Bonita Dr Suite 316 San Marcos CA 92078-5291 | |
| (760) 744-9626 | |
| (760) 744-0751 |
| Full Name | Lake San Marcos Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 1030 La Bonita Dr, San Marcos, California |
| Authorized Official Name and Position | Neil L Halim (OWNER) |
| Authorized Official Contact | 3182305487 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake San Marcos Family Medicine 1030 La Bonita Dr Suite 316 San Marcos CA 92078-5291 Ph: (760) 744-9626 | Lake San Marcos Family Medicine 1030 La Bonita Dr Suite 316 San Marcos CA 92078-5291 Ph: (760) 744-9626 |
| NPI Number | 1124392683 |
|---|---|
| Provider Enumeration Date | 03/01/2012 |
| Last Update Date | 03/01/2012 |
| Medicare PECOS PAC ID | 9931368214 |
|---|---|
| Medicare Enrollment ID | O20120306000332 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124392683 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | C53327 (California) | Primary |
| Provider Name | Neil Lutfi Halim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689623548 PECOS PAC ID: 0941238281 Enrollment ID: I20120306000355 |
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