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Organization
HP CONTINGENT
Active
Organization
HP CONTINGENT
Active
Other names
SLO Rehabilitation Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M GLEASON M.D. (PHYSICIAN)
(310) 499-8365
Entity
Organization
Contact information
Practice address
35 CASA ST, SUITE 370, SAN LUIS OBISPO, CA 93405-1818
(805) 900-0741
(805) 221-6135
Mailing address
3599 SUELDO ST, SUITE 110, SAN LUIS OBISPO, CA 93401-7386
(805) 900-0741
(805) 221-6135
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
A108043
CA
Other
Enumeration date
11/24/2015
Last updated
11/24/2015
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