| West Coast Primary Care, LLC | |
|
8250 Bryan Dairy Rd Suite 305 Largo FL 33777-1353 | |
| (727) 391-5008 | |
| (727) 938-1481 |
| Full Name | West Coast Primary Care, LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 8250 Bryan Dairy Rd, Largo, Florida |
| Authorized Official Name and Position | Giovanni Baula (PRESIDENT) |
| Authorized Official Contact | 7278248270 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Coast Primary Care, LLC 8250 Bryan Dairy Rd Suite 305 Largo FL 33777-1353 Ph: (727) 391-5008 | West Coast Primary Care, LLC 8250 Bryan Dairy Rd Suite 305 Largo FL 33777-1353 Ph: (727) 391-5008 |
| NPI Number | 1528327087 |
|---|---|
| Provider Enumeration Date | 05/03/2012 |
| Last Update Date | 05/03/2012 |
| Medicare PECOS PAC ID | 6709041585 |
|---|---|
| Medicare Enrollment ID | O20120628000371 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528327087 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 207R00000X | Internal Medicine | () | Secondary |
| Provider Name | Karen L Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417090523 PECOS PAC ID: 7416045117 Enrollment ID: I20071114000018 |
| Provider Name | Colin Chan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194710871 PECOS PAC ID: 0749474278 Enrollment ID: I20101028001326 |
| Provider Name | Jason D Philippe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982165775 PECOS PAC ID: 4284068578 Enrollment ID: I20220127002257 |
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