Organization
LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.
Active
Other names
Lags Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
HALLIE MEDINA (CONTRACTING ASSISTANT)
(661) 432-1451
Entity
Organization
Contact information
Practice address
200 S 13TH ST, GROVER BEACH, CA 93433-3302
(805) 736-7886
Mailing address
218 N I ST, LOMPOC, CA 93436-0909
(805) 736-7886
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
03/28/2019
Last updated
03/28/2019
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