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General NPI Number Information
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NPI Number | 1962707935
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Entity Type | Organization
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Legal Business Name | LAGS SPINE & SPORTSCARE MEDICAL CENTERS INC
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Dates
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Enumeration Date | 01/21/2011
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Last Update Date | 08/13/2012
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Provider Practice Location Address
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Address Line | 1105 LAS TABLAS RD SUITE C
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City | TEMPLETON
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State | CA
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Zip | 93465-9731
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Country | US
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Telephone | 805-434-5434
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Fax | 805-434-5439
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Provider Business Mailing Address
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Address Line | 135 CARMEN LN
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City | SANTA MARIA
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State | CA
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Zip | 93458-7729
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Country | US
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Telephone | 805-434-5434
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Fax | 805-434-5439
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Authorized Official
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Title or Position | PRESIDENT
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Name | FRANCIS P LAGATTUTA
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Credential | MD
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Telephone | 805-434-5434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | G84334
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License Number State | CA
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