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Organization

SIERRA VISTA MEDICAL PAVILION AMBULATORY SURGERY SUITE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES THORNTON MD (PHYSICIAN OWNER)
(805) 544-6471
Entity
Organization

Contact information

Practice address
77 CASA STREET, STE 203, SAN LUIS OBISPO, CA 93405
(805) 544-6471
(805) 544-4913
Mailing address
77 CASA STREET, STE 203, SAN LUIS OBISPO, CA 93405
(805) 544-6471
(805) 544-4913

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
G42294
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1750380374
NPI NUMBER
CA
Enumeration date
02/13/2007
Last updated
06/24/2008
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