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General NPI Number Information
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NPI Number | 1124478243
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Entity Type | Organization
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Legal Business Name | ERIC DUNLOP, DO, INC.
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Dates
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Enumeration Date | 06/20/2016
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Last Update Date | 06/20/2016
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Provider Practice Location Address
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Address Line | 148 CASA ST
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93405-1804
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Country | US
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Telephone | 805-752-1255
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Fax |
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Provider Business Mailing Address
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Address Line | 148 CASA ST
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93405-1804
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Country | US
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Telephone | 805-752-1255
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Fax |
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | ERIC W DUNLOP
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Credential | D.O.
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Telephone | 805-752-1255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A11326
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License Number State | CA
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