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NPI Code Detail

MEDICARE: ELPIDIO CEPEDA L.P.T.

MEDICARE: ELPIDIO CEPEDA L.P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1167G00000XLicensed Psychiatric TechnicianPT22240CA

General Provider Information

NPI Number : 1679631766
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELPIDIO CEPEDA L.P.T.
Provider Business Mailing Address
First Line : 1002 GRANADA ST
Second Line :
City : SANTA MARIA
State : CA
Zip : 93458-7324
Country : US
Telephone Number : 805-922-4039
Fax Number :
Provider Business Practice Location Address
First Line : 2178 JOHNSON AVE
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-4535
Country : US
Telephone Number : 805-788-2935
Fax Number : 805-781-1232
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2006
Last Update Date : 07/08/2007

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Directions to “ ELPIDIO CEPEDA L.P.T.” Practice Location

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