| Wellbridge Medical Inc. | |
|
2500 Pecho Valley Rd Los Osos CA 93402-4104 | |
| (805) 835-8865 | |
| Not Available |
| Full Name | Wellbridge Medical Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2500 Pecho Valley Rd, Los Osos, California |
| Authorized Official Name and Position | Connor Vanderveer Johnson (MEDICAL DIRECTOR) |
| Authorized Official Contact | 8058358865 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellbridge Medical Inc. 4280 La Posada San Luis Obispo CA 93401-7939 Ph: () - | Wellbridge Medical Inc. 2500 Pecho Valley Rd Los Osos CA 93402-4104 Ph: (805) 835-8865 |
| NPI Number | 1912681354 |
|---|---|
| Provider Enumeration Date | 06/14/2023 |
| Last Update Date | 05/03/2024 |
| Medicare PECOS PAC ID | 4284098260 |
|---|---|
| Medicare Enrollment ID | O20230908002254 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912681354 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Kelly C Jenei |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386992048 PECOS PAC ID: 0648402073 Enrollment ID: I20140416002364 |
| Provider Name | Connor V Johnson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780010603 PECOS PAC ID: 8325322431 Enrollment ID: I20170308001245 |
| Provider Name | Katie Anne Colvard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477082188 PECOS PAC ID: 4082986153 Enrollment ID: I20170824000992 |
| Provider Name | Leslie Ann Kazia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316410574 PECOS PAC ID: 8729329198 Enrollment ID: I20190411002263 |
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