Individual provider Active NPI

Dale Ethan Ekstrum, MD

  • Family Medicine Physician
  • Lompoc, CA
National Provider Identifier
1225106602
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G69286 Issued in CA
Practice address
217 W Central Ave Ste a
Lompoc, CA 93436-2830
Phone
(805) 735-4999
Fax
(805) 294-1711
NPI assigned
Dec 1, 2006
Last updated
Aug 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G69286 CA Primary

Addresses

Primary practice location

217 W Central Ave Ste a
Lompoc, CA 93436-2830

Mailing address

117 West Bunny Avenue
Santa Maria, CA 93458-2805
Phone (805) 735-4292

Other identifiers 1

IdentifierTypeStateIssuer
CB207338OtherCAMEDICARE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041115000574 CA Practitioner - Family PracticePractitioner - Other (Physician) 6901867274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Irvine, California College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

217 W Central Ave
Suite a
Lompoc, CA 93436-2830
Phone (805) 735-4999

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions34
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
69286CAMDPharmacist
G69286CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dale Ekstrum MD Inc Family Medicine CurrentSince Sep 2, 2004 Accepting new patients
Lompoc Valley Medical Center Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

217 W Central Ave
Ste A
Lompoc, CA 93436
Phone (805) 735-4999

217 W Central Ave
Ste G
Lompoc, CA 93436
Phone (805) 735-4292

3010 Beard Rd
Napa, CA 94558
Phone (707) 257-1550

Interoperability endpoints

  • Direct secure messaging: dale.ekstrum@226768656465924.direct.elationemr.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1225106602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 WEST BUNNY AVENUE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934582805",
            "telephone_number": "805-735-4292",
            "fax_number": "805-735-4293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 W CENTRAL AVE STE A",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934362830",
            "telephone_number": "805-735-4999",
            "fax_number": "805-294-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKSTRUM",
        "first_name": "DALE",
        "middle_name": "ETHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G69286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "CB207338",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lompoc, CA

Sources for this page

Verify at the official NPI Registry.