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General NPI Number Information
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NPI Number | 1720025729
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Entity Type | Individual
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Provider Name | DELANE OWEN PRICE PA-C
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Gender | Male
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 08/22/2014
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Provider Practice Location Address
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Address Line | 116 S PALISADE DR SUITE 206
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City | SANTA MARIA
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State | CA
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Zip | 93454-8904
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Country | US
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Telephone | 805-614-9250
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Fax | 805-614-9260
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Provider Business Mailing Address
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Address Line | 116 S PALISADE DR SUITE 206
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City | SANTA MARIA
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State | CA
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Zip | 93454-8904
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Country | US
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Telephone | 805-614-9250
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Fax | 805-614-9260
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA13405
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License Number State | CA
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