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NPI Code Detail

MEDICARE: SAN LUIS COASTAL UNIFIED SCHOOL DISTRICT

MEDICARE: SAN LUIS COASTAL UNIFIED SCHOOL DISTRICT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251300000XLocal Education Agency (LEA)

General Provider Information

NPI Number : 1033261961
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAN LUIS COASTAL UNIFIED SCHOOL DISTRICT
Provider Business Mailing Address
First Line : 1500 LIZZIE ST # F-1
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-3062
Country : US
Telephone Number : 805-549-1331
Fax Number :
Provider Business Practice Location Address
First Line : 1500 LIZZIE ST # F-1
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-3062
Country : US
Telephone Number : 805-549-1331
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF BUSINESS SERVICES
Name : MR. RUSSELL MILLER
Credential :
Telephone Number : 805-549-1331
Provider Enumeration Date : 01/18/2007
Last Update Date : 08/22/2020

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Directions to “SAN LUIS COASTAL UNIFIED SCHOOL DISTRICT ” Practice Location

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