| San Luis Obispo Family Healthcare A Medical Corporation | |
|
1250 Peach St Ste A San Luis Obispo CA 93401-2871 | |
| (805) 596-0900 | |
| (805) 596-0411 |
| Full Name | San Luis Obispo Family Healthcare A Medical Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 1250 Peach St, San Luis Obispo, California |
| Authorized Official Name and Position | Laurence H Lotz (PRESIDENT) |
| Authorized Official Contact | 8055960900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Luis Obispo Family Healthcare A Medical Corporation 1250 Peach St Ste A San Luis Obispo CA 93401-2871 Ph: (805) 596-0900 | San Luis Obispo Family Healthcare A Medical Corporation 1250 Peach St Ste A San Luis Obispo CA 93401-2871 Ph: (805) 596-0900 |
| NPI Number | 1033111224 |
|---|---|
| Provider Enumeration Date | 06/01/2005 |
| Last Update Date | 01/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033111224 | NPI | - | NPPES |
| GR0094260 | Medicaid | CA | |
| ZZZ04910Z | Other | CA | BLUE SHIELD OF CA GRP PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2415081 (California) | Primary |
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