Organization
COUNTY OF SAN LUIS OBISPO
Active
Other names
San Luis Obispo Psychiatric Health Facility
Organization subpart
No
Provider details
NPI number
Authorized official
DR. M. DAISY ILANO M.D. (MENTAL HEALTH DIRECTOR)
(805) 781-4700
Entity
Organization
Contact information
Practice address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4700
(805) 781-1273
Mailing address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4700
(805) 781-1273
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
02016035
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4048
—
CA
Enumeration date
06/22/2007
Last updated
08/22/2013
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