Organization
DALE EKSTRUM MD INC
Active
Other names
Urgent Care Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE ETHAN EKSTRUM MD (CEO)
(805) 735-4292
Entity
Organization
Contact information
Practice address
217 W CENTRAL AVE, SUITE G, LOMPOC, CA 93436-2830
(805) 735-4292
(805) 735-4293
Mailing address
217 W CENTRAL AVE, SUITE G, LOMPOC, CA 93436-2830
(805) 735-4292
(805) 735-4293
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G69286
CA
Other
Enumeration date
09/24/2007
Last updated
09/24/2007
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