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Organization
SAN LUIS INTERNAL MEDICINE ASSOCIATES, A MEDICAL CORPORATION
Active
Organization
SAN LUIS INTERNAL MEDICINE ASSOCIATES, A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH A CHERRY MD (PRESIDENT)
(805) 439-1381
Entity
Organization
Contact information
Practice address
4251 S HIGUERA ST STE 701, SAN LUIS OBISPO, CA 93401-7742
(805) 439-1381
(805) 439-0138
Mailing address
4251 S HIGUERA ST STE 701, SAN LUIS OBISPO, CA 93401-7742
(805) 439-1381
(805) 439-0138
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2371545
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0996840
CLIA
CA
01
—
ZZZ03051Z
BLUE SHIELD OF CA GRP#
CA
Enumeration date
11/21/2005
Last updated
10/30/2023
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