Organization
COUNTY OF SAN LUIS OBISPO
Active
Other names
JUDKINS MIDDLE SCHOOL
Organization subpart
No
Provider details
NPI number
Authorized official
M DAISY ILANO MD (MEDICAL DIRECTOR)
(805) 781-4700
Entity
Organization
Contact information
Practice address
680 WADSWORTH AVE, PISMO BEACH, CA 93449-2359
(805) 781-4700
Mailing address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/29/2014
Last updated
09/29/2014
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