| Ocean Breeze Medical Group, Inc. | |
|
150 Avenida Cabrillo Ste A San Clemente CA 92672-5595 | |
| (949) 369-6993 | |
| Not Available |
| Full Name | Ocean Breeze Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 150 Avenida Cabrillo Ste A, San Clemente, California |
| Authorized Official Name and Position | Ricardo Davalos (OWNER) |
| Authorized Official Contact | 9493696993 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ocean Breeze Medical Group, Inc. 150 Avenida Cabrillo Ste A San Clemente CA 92672-5595 Ph: (949) 369-6993 | Ocean Breeze Medical Group, Inc. 150 Avenida Cabrillo Ste A San Clemente CA 92672-5595 Ph: (949) 369-6993 |
| NPI Number | 1386790400 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 12/13/2010 |
| Medicare PECOS PAC ID | 3971530825 |
|---|---|
| Medicare Enrollment ID | O20050721000731 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386790400 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A065157 (California) | Primary |
| Provider Name | Ricardo Davalos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609804749 PECOS PAC ID: 1951214709 Enrollment ID: I20120223000123 |
Care Gastroenterology Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 655 Camino De Los Mares, Sute 123, San Clemente, CA 92673 Phone: 949-443-1546 Fax: 949-443-1077 | |
Active Life Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 380 Camino De Estrella, San Clemente, CA 92672 Phone: 949-487-1231 | |
California Rehabilitation & Sports Therapy A California Physical Ther Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 415 E Avenida Pico, San Clemente, CA 92672 Phone: 949-245-6581 Fax: 949-688-2136 | |
Inchel Yeam Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 675 Camino De Los Mares Ste 200, San Clemente, CA 92673 Phone: 949-489-8783 | |
San Clemente Internal Medical Group Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 665 Camino De Los Mares Ste 309, San Clemente, CA 92673 Phone: 949-487-9034 Fax: 949-493-3721 | |
Joomo Yang, Md., Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2403 Camino Corso Rio, San Clemente, CA 92673 Phone: 949-226-8416 Fax: 949-226-8019 | |
Hybrid Md Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1031 Avenida Pico, Sutie 103, San Clemente, CA 92673 Phone: 202-904-8490 |