Organization
LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY D'AMATO (CONTRACTING MANAGER)
(805) 264-3388
Entity
Organization
Contact information
Practice address
7275 E SOUTHGATE DR STE 306, SACRAMENTO, CA 95823-2631
(916) 800-1117
(916) 800-1118
Mailing address
218 N I ST, LOMPOC, CA 93436-0909
(805) 736-7886
(805) 736-7867
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
—
Other
Enumeration date
01/22/2019
Last updated
01/22/2019
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