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Organization
INDUSTRIAL MEDICAL GROUP OF SANTA MARIA VALLEY
Active
Organization
INDUSTRIAL MEDICAL GROUP OF SANTA MARIA VALLEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIMON BOUGHEY M.D. (MEDICAL DIRECTOR)
(805) 922-8282
Entity
Organization
Contact information
Practice address
3070 SKYWAY DR STE 106, SANTA MARIA, CA 93455-1830
(805) 922-8282
(805) 925-2690
Mailing address
3070 SKYWAY DR STE 106, SANTA MARIA, CA 93455-1830
(805) 922-8282
(805) 925-2690
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
G50357
CA
Other
Enumeration date
11/04/2008
Last updated
11/04/2008
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