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General NPI Number Information
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NPI Number | 1346365780
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Entity Type | Organization
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Legal Business Name | SAN LUIS OBISPO PUBLIC HEALTH
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2191 JOHNSON AVE
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-4534
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Country | US
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Telephone | 805-781-5500
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Fax | 805-781-5543
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Provider Business Mailing Address
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Address Line | 2191 JOHNSON AVE
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-4534
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Country | US
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Telephone | 805-781-5500
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Fax | 805-781-5543
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Authorized Official
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Title or Position | HEALTH OFFICER
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Name | DR. GREGORY W THOMAS
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Credential | M.D.
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Telephone | 805-781-5519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | G46138
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License Number State | CA
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