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General NPI Number Information
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NPI Number | 1295718849
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Entity Type | Organization
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Legal Business Name | MED-STOPS MEDICAL CLINIC, INC.
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Dates
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Enumeration Date | 11/28/2005
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 283 MADONNA RD SUITE B
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93405-5432
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Country | US
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Telephone | 805-549-8880
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Fax | 805-783-2009
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Provider Business Mailing Address
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Address Line | 283 MADONNA RD SUITE B
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93405-5432
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Country | US
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Telephone | 805-549-8880
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Fax | 805-783-2009
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN M. ROBERTS
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Credential | M.D.
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Telephone | 805-549-8880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number | 22211568
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License Number State | CA
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