DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MR. TOM E BLANCO MAT, ATC

MEDICARE: MR. TOM E BLANCO MAT, ATC
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
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1578784294
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TOM E BLANCO MAT, ATC
Provider Business Mailing Address
First Line : 515 W COLLEGE AVE
Second Line :
City : LOMPOC
State : CA
Zip : 93436-4401
Country : US
Telephone Number : 805-742-3000
Fax Number :
Provider Business Practice Location Address
First Line : 515 W COLLEGE AVE
Second Line :
City : LOMPOC
State : CA
Zip : 93436-4401
Country : US
Telephone Number : 805-742-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 07/08/2007

Similar Medicare Providers

1407705486 — EVELYN ACOSTA
Practice Location Address:
515 W COLLEGE AVE
LOMPOC, CA
93436-4401
Practice Phone: 805-742-3000
Practice Fax:
1881484491 — LANA HUYCK PPS CREDENTIAL
Practice Location Address:
515 W COLLEGE AVE
LOMPOC, CA
93436-4401
Practice Phone: 805-742-2975
Practice Fax:
1750171377 — AMARGIETE BELL PPS
Practice Location Address:
515 W COLLEGE AVE
LOMPOC, CA
93436-4401
Practice Phone: 805-742-3000
Practice Fax:
1821888447 — CARINA D GUTIERREZ PPS
Practice Location Address:
515 W COLLEGE AVE
LOMPOC, CA
93436-4401
Practice Phone: 805-742-3113
Practice Fax:
1922898378 — CARLA DEWEY MS, PPS
Practice Location Address:
515 W COLLEGE AVE
LOMPOC, CA
93436-4401
Practice Phone: 805-742-2972
Practice Fax:
1467243915 — DAWN MANALO
Practice Location Address:
515 W COLLEGE AVE
LOMPOC, CA
93436-4401
Practice Phone: 805-345-5920
Practice Fax:

Directions to “ MR. TOM E BLANCO MAT, ATC” 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.