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Organization

COUNTY OF SAN LUIS OBISPO

Active
Other names
Virginia Peterson Elementary School
Organization subpart
No

Provider details

NPI number
Authorized official
M DAISY ILANO M.D (MEDICAL DIRECTOR)
(805) 781-4700
Entity
Organization

Contact information

Practice address
2501 BEECHWOOD DR, PASO ROBLES, CA 93446-4730
(805) 769-1250
Mailing address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4700

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
10/14/2016
Last updated
10/14/2016
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