# LOMPOC VALLEY MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Convalescent Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376539130
- **Authorized official:** MR. DUSTIN CHENEY (CFO)
- **Authorized official phone:** (805) 737-3306

## Contact information

- **Practice address:** 216 N 3RD ST, LOMPOC, CA 93436-6104
- **Practice address phone:** (805) 737-3367
- **Mailing address:** 216 N 3RD ST, LOMPOC, CA 93436-6104
- **Mailing address phone:** (805) 737-3367

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 09/26/2005
- **Last updated:** 12/23/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZT05256G | — | CA |
| 05 | — | ZZT30110F | — | CA |
| 05 | — | ZZT40110F | — | CA |