Organization
CALIFORNIA POLYTECHNIC STATE UNIVERSITY AT SAN LUIS OBISPO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA HADAWAY-MELLIS (AVP FOR STUDENT AFFAIRS HEALTH)
(805) 756-5206
Entity
Organization
Contact information
Practice address
1 GRAND AVE, SAN LUIS OBISPO, CA 93407-9000
(805) 756-1211
Mailing address
1 GRAND AVE, SAN LUIS OBISPO, CA 93407-9000
(805) 756-1211
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
RN 348161
CA
Other
Enumeration date
12/14/2006
Last updated
03/24/2026
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