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Organization
FAMILY & INDUSTRIAL MEDICAL CENTER, INC.
Active
Organization
FAMILY & INDUSTRIAL MEDICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BARBARA M LANDIS (OFFICE MANAGER)
(805) 547-1255
Entity
Organization
Contact information
Practice address
47 SANTA ROSA ST, SAN LUIS OBISPO, CA 93405-5816
(805) 542-9596
(805) 542-0845
Mailing address
47 SANTA ROSA ST, SAN LUIS OBISPO, CA 93405-5816
(805) 542-9596
(805) 542-0845
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ27461Z
BLUE SHIELD
CA
Enumeration date
03/13/2007
Last updated
06/16/2014
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