Healthcare Provider Details

I. General information

NPI: 1548664717
Provider Name (Legal Business Name): TROY I MOUNTS, M.D.,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 01/02/2020
Certification Date: 01/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 SAN PALO RD
ATASCADERO CA
93422-2481
US

IV. Provider business mailing address

PO BOX 1737
SAN LUIS OBISPO CA
93406-1737
US

V. Phone/Fax

Practice location:
  • Phone: 805-544-2500
  • Fax: 805-544-0832
Mailing address:
  • Phone: 805-544-2500
  • Fax: 805-544-0832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: BETH G HUTCHINSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 805-544-2500