Organization
CENTRAL COAST OTOLARYNGOLOGY
Active
Other names
Richard P Wikholm MD, Inc, Sleep Disorders Center of Santa Maria
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH WIKHOLM (OFFICE MANAGER)
(805) 614-9250
Entity
Organization
Contact information
Practice address
116 S PALISADE DR, SUITE 206, SANTA MARIA, CA 93454-8904
(805) 614-9250
Mailing address
116 S PALISADE DR, STE 206, SANTA MARIA, CA 93454-8904
(805) 614-9250
(805) 614-9260
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
207YS0012X
Sleep Medicine (Otolaryngology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CL711A
MEDICARE PTAN
CA
Enumeration date
10/01/2009
Last updated
11/29/2018
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