Individual
DIETER ERNST ECKERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1551 BISHOP ST, SAN LUIS OBISPO, CA 93401-4635
(805) 269-1300
(805) 269-1387
Mailing address
150 TEJAS PL, NIPOMO, CA 93444-9123
(805) 929-3211
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G21039
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC71031F
—
CA
Enumeration date
07/14/2006
Last updated
02/05/2010
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