Organization
EAR NOSE AND THROAT MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD ALLEN HENDRICKS M.D. (PRESIDENT)
(805) 434-1836
Entity
Organization
Contact information
Practice address
1050 LAS TABLAS RD, TEMPLETON, CA 93465-9729
(805) 434-1836
(805) 434-1590
Mailing address
1050 LAS TABLAS RD, TEMPLETON, CA 93465-9729
(805) 434-1836
(805) 434-1590
Taxonomy
Speciality
Code
Description
License number
State
207YX0602X
Otolaryngic Allergy Physician
Primary
G19580
CA
Other
Enumeration date
05/31/2005
Last updated
12/03/2008
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