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Organization

UNITED CEREBRAL PALSY

Active
Other names
Ride-On transportation
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARK SHAFFER (DIRECTOR)
(805) 541-8747
Entity
Organization

Contact information

Practice address
3620 SACRAMENTO DR, SUITE 201, SAN LUIS OBISPO, CA 93401-7215
(805) 541-8747
(805) 543-2045
Mailing address
3620 SACRAMENTO DRIVE, SUITE 201, SAN LUIS OBISPO, CA 93401
(805) 541-8747
(805) 543-2045

Taxonomy

Speciality
Code
Description
License number
State
347B00000X
Bus
Primary
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MTN00696F
CA
Enumeration date
11/08/2006
Last updated
08/22/2020
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