Individual provider Active NPI

Pierre Georges Labrecque, M.D.

  • Specialist
  • Santa Maria, CA
National Provider Identifier
1902867294
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
C043006 Issued in CA
Practice address
120 N Miller St Ste C
Santa Maria, CA 93454-4557
Phone
(805) 739-0033
Fax
(805) 739-1712
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X C043006 CA Primary

Addresses

Primary practice location

120 N Miller St Ste C
Santa Maria, CA 93454-4557

Mailing address

120 N Miller St
Building C
Santa Maria, CA 93454-4557
Phone (805) 739-0033

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
I20110104000690 CA Practitioner - Dermatology 5597954719 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C043006CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Spa Med Inc CurrentSince Jun 22, 2022 Accepting new patients
Dignity Health Past Accepting new patients

Locations

6000 Physicians Blvd
Ste 210
Bakersfield, CA 93301
Phone (661) 325-9312

340 James Way
Ste 140
Pismo Beach, CA 93449
Phone (805) 574-1000

300 James Way
Ste 140
Pismo Beach, CA 93449
Phone (805) 574-1000

120 N Miller St
Bldg Bc
Santa Maria, CA 93454
Phone (805) 739-0033

120 N Miller St
Ste C
Santa Maria, CA 93454
Phone (805) 473-9735

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1902867294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N MILLER ST",
            "address_2": "BUILDING C",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934544557",
            "telephone_number": "805-739-0033",
            "fax_number": "805-739-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N MILLER ST STE C",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934544557",
            "telephone_number": "805-739-0033",
            "fax_number": "805-739-1712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABRECQUE",
        "first_name": "PIERRE",
        "middle_name": "GEORGES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "C043006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.