Organization
COUNTY OF SAN LUIS OBISPO
Active
Other names
MORRO BAY HIGH 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
235 ATASCADERO RD, MORRO BAY, CA 93442-1516
(805) 781-4700
(805) 781-1273
Mailing address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4700
(805) 781-1273
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
CA
Other
Enumeration date
11/15/2011
Last updated
09/24/2014
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