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General NPI Number Information
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NPI Number | 1760637896
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Entity Type | Organization
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Legal Business Name | SAN LUIS HOSPITALISTS A MEDICAL CORPORATION
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Dates
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Enumeration Date | 11/17/2008
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Last Update Date | 11/09/2022
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Provider Practice Location Address
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Address Line | 1911 JOHNSON AVE
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-4197
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Country | US
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Telephone | 805-543-5353
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Fax | 805-542-6661
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Provider Business Mailing Address
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Address Line | PO BOX 1464
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93406-1464
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | PATRICIA KELLER
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Credential |
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Telephone | 805-503-8422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State | CA
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