Healthcare Provider Details

I. General information

NPI: 1972829224
Provider Name (Legal Business Name): PEDIATRIC INPATIENT SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2010
Last Update Date: 10/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E CHURCH ST
SANTA MARIA CA
93454-5906
US

IV. Provider business mailing address

3000 BROAD ST SUITE B-217
SAN LUIS OBISPO CA
93401-6786
US

V. Phone/Fax

Practice location:
  • Phone: 805-739-3600
  • Fax: 805-739-3075
Mailing address:
  • Phone: 805-547-1255
  • Fax: 805-547-1395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HILLEL K JANAI
Title or Position: PRESIDENT
Credential: MD
Phone: 805-220-8232