MEDICARE: EAR NOSE AND THROAT MEDICAL CLINIC INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207YX0602X	Otolaryngic Allergy Physician	G19580	CA

General Provider Information

NPI Number	:	1043212376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAR NOSE AND THROAT MEDICAL CLINIC INC

Provider Business Mailing Address
First Line	:	1050 LAS TABLAS RD
Second Line	:
City	:	TEMPLETON
State	:	CA
Zip	:	93465-9729
Country	:	US
Telephone Number	:	805-434-1836
Fax Number	:	805-434-1590

Provider Business Practice Location Address
First Line	:	1050 LAS TABLAS RD
Second Line	:
City	:	TEMPLETON
State	:	CA
Zip	:	93465-9729
Country	:	US
Telephone Number	:	805-434-1836
Fax Number	:	805-434-1590

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RICHARD ALLEN HENDRICKS
Credential	:	M.D.
Telephone Number	:	805-434-1836

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	12/03/2008

Similar Medicare Providers

1245214576 — DR. RICHARD ALLAN PETERSON M.D.
Practice Location Address:

1050 LAS TABLAS RD , SUITE 13
TEMPLETON, CA
93465-9729

Practice Phone: 805-434-1435
Practice Fax: 805-434-3747

1407832058 — DR. WARREN H. FRANKEL M.D.
Practice Location Address:

1050 LAS TABLAS RD , SUITE 15
TEMPLETON, CA
93465-9729

Practice Phone: 805-434-3390
Practice Fax: 805-434-3391

1679524854 — JANICE C ORTIZ-SINGH MD
Practice Location Address:

1050 LAS TABLAS RD , SUITE 16
TEMPLETON, CA
93465-9729

Practice Phone: 805-434-1038
Practice Fax:

1467403519 — DEBRA A TURULL DO
Practice Location Address:

1050 LAS TABLAS RD , SUITE 2
TEMPLETON, CA
93465-9729

Practice Phone: 805-434-3818
Practice Fax: 805-434-2566

1508886235 — DR. SHIELDS BREWSTER ABERNATHY M.D.
Practice Location Address:

1050 LAS TABLAS RD , SUITE 3
TEMPLETON, CA
93465-9729

Practice Phone: 805-434-1000
Practice Fax: 805-434-3265

1275553497 — DR. STEFANIE ANN MIKULICS M.D.
Practice Location Address:

1050 LAS TABLAS RD , SUITE 2
TEMPLETON, CA
93465-9729

Practice Phone: 805-434-9441
Practice Fax: 805-434-9456

Directions to “EAR NOSE AND THROAT MEDICAL CLINIC INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.