Organization
CALIFORNIA POLYTECHNIC STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES MATTHEW EGGEN ATC (ASSISTANT ATHLETIC TRAINER)
(805) 756-5491
Entity
Organization
Contact information
Practice address
1 GRAND AVE, SAN LUIS OBISPO, CA 93407-9000
(805) 756-5491
Mailing address
13020 ATASCADERO RD, ATASCADERO, CA 93422-5902
(805) 458-5193
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
CA
Other
Enumeration date
03/19/2007
Last updated
08/22/2020
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