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Individual

ANDRE MARCEL ACEBO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
325 POSADA LN, SUITE A-C, TEMPLETON, CA 93465-4003
(805) 542-6700
(805) 542-6791
Mailing address
2050 S BLOSSER RD, SANTA MARIA, CA 93458-7310
(805) 361-8028
(805) 361-8097

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
DC 20074
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
FHC70936F
TEMPLETON M/CAL #
CA
01
W1508
MEDICARE GROUP NUMBER
CA
01
W1508A
CHCCC, TEMPLETON MEDICARE GROUP #
CA
Enumeration date
07/10/2006
Last updated
06/18/2021
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