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Organization
ST MICHAEL NEPHROLOGY, PC
Active
Organization
ST MICHAEL NEPHROLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERNEST DANIEL MORENO DYTIAPCO MD (PRESIDENT)
(805) 792-2274
Entity
Organization
Contact information
Practice address
620 CALIFORNIA BLVD BLDG B, SUITE P1, SAN LUIS OBISPO, CA 93401-2541
(805) 792-2274
Mailing address
620 CALIFORNIA BLVD BLDG B, SUITE P1, SAN LUIS OBISPO, CA 93401-2541
(805) 792-2274
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
10/17/2022
Last updated
10/17/2022
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