| Mark a Ward MD Inc | |
|
355 Las Vegas St Morro Bay CA 93442-1548 | |
| (805) 772-7100 | |
| (805) 772-7776 |
| Full Name | Mark a Ward MD Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 355 Las Vegas St, Morro Bay, California |
| Authorized Official Name and Position | Mark Alan Ward (OWNER) |
| Authorized Official Contact | 8057727100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark a Ward MD Inc 355 Las Vegas St Morro Bay CA 93442-1548 Ph: (805) 772-7100 | Mark a Ward MD Inc 355 Las Vegas St Morro Bay CA 93442-1548 Ph: (805) 772-7100 |
| NPI Number | 1548463359 |
|---|---|
| Provider Enumeration Date | 06/08/2007 |
| Last Update Date | 01/29/2014 |
| Medicare PECOS PAC ID | 5092814525 |
|---|---|
| Medicare Enrollment ID | O20070625000729 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548463359 | NPI | - | NPPES |
| 00A836860 | Other | CA | BLUE SHIELD |
| P00259106 | Other | CA | RAILROAD MEDICARE |
| 00A836860 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| Provider Name | Mark a Ward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639110257 PECOS PAC ID: 5799699484 Enrollment ID: I20031117000801 |
| Provider Name | Carly B Lepp |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1538594163 PECOS PAC ID: 2163654625 Enrollment ID: I20160114002634 |
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