Healthcare Provider Details

I. General information

NPI: 1750716247
Provider Name (Legal Business Name): FIRST CHOICE PHYSICIAN PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2013
Last Update Date: 11/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 CASA ST SUITE 104
SAN LUIS OBISPO CA
93405-5803
US

IV. Provider business mailing address

77 CASA ST SUITE 104
SAN LUIS OBISPO CA
93405-5803
US

V. Phone/Fax

Practice location:
  • Phone: 805-595-1808
  • Fax: 805-595-1815
Mailing address:
  • Phone: 805-541-6225
  • Fax: 805-541-6201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RONALD KAUFMAN
Title or Position: REGIONAL CMO; TENET
Credential:
Phone: 714-428-6812