Individual
LANT JARVIS ABERNATHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
862 MEINECKE AVE STE 204, SAN LUIS OBISPO, CA 93405-3703
(805) 540-5770
(888) 851-4755
Mailing address
PO BOX 759, GROVER BEACH, CA 93483-0759
(805) 712-6867
(888) 851-4755
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E5955
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E2424420
DRIVERS LISCENSE
CA
01
—
E5955
CA MEDICAL LICENSE
CA
Enumeration date
05/05/2019
Last updated
01/26/2024
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