Healthcare Provider Details

I. General information

NPI: 1093717472
Provider Name (Legal Business Name): AARON D. KROMHOUT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 BISHOP ST STE B240
SAN LUIS OBISPO CA
93401-4635
US

IV. Provider business mailing address

2050 S BLOSSER RD
SANTA MARIA CA
93458-7310
US

V. Phone/Fax

Practice location:
  • Phone: 805-549-0402
  • Fax: 805-549-0465
Mailing address:
  • Phone: 805-361-8030
  • Fax: 805-361-8097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberA88432
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: