Provider Demographics
NPI:1194711952
Name:LOMPOC VALLEY MEDICAL CENTER
Entity type:Organization
Organization Name:LOMPOC VALLEY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PFS
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ONDRIZEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-737-3321
Mailing Address - Street 1:1515 EAST OCEAN
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-7337
Mailing Address - Country:US
Mailing Address - Phone:805-737-3300
Mailing Address - Fax:
Practice Address - Street 1:1515 EAST OCEAN
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-7337
Practice Address - Country:US
Practice Address - Phone:805-737-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-26
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT30110FMedicaid
CAZZT05256GMedicaid
CAZZT40110FMedicaid
CA050110Medicare Oscar/Certification