Organization
SANTA MARIA GASTROENTEROLOGY MEDICAL GROUP INC.
Active
Organization
SANTA MARIA GASTROENTEROLOGY MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC W JAHNKE M.D. (PARTNER)
(805) 922-6991
Entity
Organization
Contact information
Practice address
1311 S MILLER ST, 100, SANTA MARIA, CA 93454-6900
(805) 922-6991
(805) 922-7052
Mailing address
1311 S MILLER ST, 100, SANTA MARIA, CA 93454-6900
(805) 922-6991
(805) 922-7052
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386971687
—
CA
01
—
CLM 00342820
CLIA
CA
01
—
DS163A
PTAN
CA
Enumeration date
11/06/2009
Last updated
07/23/2012
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