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Organization
LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.
Active
Organization
LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.
Active
Other names
Lags Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
HALLIE MEDINA (CONTRACTING ASSISTANT)
(661) 432-1451
Entity
Organization
Contact information
Practice address
200 S 13TH ST, GROVER BEACH, CA 93433-3302
(805) 736-7886
Mailing address
218 N I ST, LOMPOC, CA 93436-0909
(805) 736-7886
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
03/28/2019
Last updated
03/28/2019
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