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General NPI Number Information
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NPI Number | 1376973974
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Entity Type | Organization
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Legal Business Name | SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY
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Dates
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Enumeration Date | 11/18/2013
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Last Update Date | 11/18/2013
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Provider Practice Location Address
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Address Line | 4050 CALLE REAL
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City | SANTA BARBARA
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State | CA
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Zip | 93110-3413
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Country | US
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Telephone | 805-685-9525
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Fax | 805-964-0540
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Provider Business Mailing Address
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Address Line | 4050 CALLE REAL
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City | SANTA BARBARA
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State | CA
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Zip | 93110-3413
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Country | US
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Telephone | 805-685-9525
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Fax | 805-964-0540
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Authorized Official
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Title or Position | SITE DIRECTOR
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Name | MR. ARMANDO RIVERA
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Credential |
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Telephone | 805-562-1641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 953869541
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License Number State | CA
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