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Organization

LAGS SPINE & SPORTSCARE CENTRAL COAST MEDICAL INC

Active
Other names
Lags Wellness & Diagnostic Center
Organization subpart
No

Provider details

NPI number
Authorized official
FRANCIS P LAGATTUTA MD (PRESIDENT)
(805) 925-9581
Entity
Organization

Contact information

Practice address
201 N COLLEGE DR, SUITE 101, SANTA MARIA, CA 93454-4614
(805) 925-9581
(805) 925-5625
Mailing address
201 N COLLEGE DR, SUITE 101, SANTA MARIA, CA 93454-4614
(805) 925-9581
(805) 925-5625

Taxonomy

Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9538454
AETNA HEALTH -GROUP PROVIDER NUMBER
CA
01
C2476390
STATE CORPORATION NUMBER
CA
01
ZZZ58838Y
BLUESHIELD OF CA GROUP PROVIDER NUMBER
CA
Enumeration date
12/31/2009
Last updated
08/13/2012
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