Organization
SAN LUIS IMAGING MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED S VERNACCHIA M.D. (PRESIDENT)
(805) 542-9700
Entity
Organization
Contact information
Practice address
1100 MONTEREY ST # 200, SAN LUIS OBISPO, CA 93401-3102
(805) 542-9700
(805) 542-0584
Mailing address
1100 MONTEREY ST # 200, SAN LUIS OBISPO, CA 93401-3102
(805) 542-9700
(805) 542-0584
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
FNP27421
CA
Other
Enumeration date
05/22/2014
Last updated
03/26/2026
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