Organization
NICK L. GUNASAYAN, D.P.M., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICK L GUNASAYAN D.P.M. (PODIATRIST)
(805) 540-5770
Entity
Organization
Contact information
Practice address
862 MEINECKE AVE, STE #204, SAN LUIS OBISPO, CA 93405-1721
(805) 540-5770
(888) 851-4755
Mailing address
1310 LAS TABLAS RD, 205, TEMPLETON, CA 93465-9737
(805) 540-5770
(888) 851-4755
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
5797150001
CA
332B00000X
Durable Medical Equipment & Medical Supplies
E4414
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E4414
STATE LICENSE
CA
Enumeration date
04/28/2008
Last updated
06/02/2014
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