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Individual

LAUREN ELVIRA MIRABDOLLAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
77 CASA ST, SUITE 201-204, SAN LUIS OBISPO, CA 93405-5803
(805) 269-1500
(805) 269-1585
Mailing address
2050 S BLOSSER RD, SANTA MARIA, CA 93458-7310
(805) 361-8028
(805) 361-8097

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95000334
CA

Other

Enumeration date
04/08/2014
Last updated
08/24/2015
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