Organization
AFFILIATED PATHOLOGISTS OF THE CENTRAL COAST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY ANTONIO (BOOKKEEPER)
(805) 710-7308
Entity
Organization
Contact information
Practice address
1911 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4131
(805) 543-5353
Mailing address
PO BOX 5007, SAN LUIS OBISPO, CA 93403-5007
(805) 710-7308
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
05D0586788
CA
Other
Enumeration date
02/20/2013
Last updated
06/20/2024
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