BENJAMIN OLMEDO PA-C NPI 1457617383

NPI Information

  • NPI: 1457617383
  • Provider Name: BENJAMIN OLMEDO, PA-C
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 217 W CENTRAL AVE STE G
    LOMPOC, CA
    ZIP 93436
  • Phone: (805) 735-4292

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NPI Details

Benjamin Olmedo, PA-C is a medical physician assistant in Lompoc, CA. Benjamin Olmedo, PA-C NPI is 1457617383. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

217 W CENTRAL AVE STE G
LOMPOC, CA
ZIP 93436-830
Phone: (805) 735-4292
Fax: (805) 735-4293

The NPI 1457617383 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/4/2012 and was last updated on 11/3/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician Assistant1039ALASKANo
2363AM0700XPhysician AssistantMedicalPA52451CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1MDA0484MEDICAIDCALIFORNIA
2MDA0484MEDICAIDALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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