Individual
DR. NICK LADDHAPHOL GUNASAYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
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
E4414
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E4414
STATE LICENSE
CA
Enumeration date
05/25/2006
Last updated
01/26/2024
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