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NPI Code Detail

MEDICARE: WESTERN MEDICAL ASSOCIATES

MEDICARE: WESTERN MEDICAL ASSOCIATES
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
1207Q00000XFamily Medicine PhysicianCA

General Provider Information

NPI Number : 1912919309
Entity Type Code : Organization
Provider Name (Legal Business Name) : WESTERN MEDICAL ASSOCIATES
Provider Business Mailing Address
First Line : 1595 SOQUEL DR STE 330
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95065-1722
Country : US
Telephone Number : 831-465-7778
Fax Number : 831-475-0351
Provider Business Practice Location Address
First Line : 13350 BIG BASIN WAY
Second Line :
City : BOULDER CREEK
State : CA
Zip : 95006-9237
Country : US
Telephone Number : 831-338-6491
Fax Number : 831-338-2767
Authorized Official
Title or Position : PHYSICIAN
Name : MR. ROBERT KEET
Credential : M.D.
Telephone Number : 831-465-7778
Provider Enumeration Date : 08/13/2006
Last Update Date : 07/21/2022

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Directions to “WESTERN MEDICAL ASSOCIATES ” Practice Location

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