Provider Demographics
NPI:1326229014
Name:SAN LUIS OBISPO PUBLIC HEALTH DEPT
Entity Type:Organization
Organization Name:SAN LUIS OBISPO PUBLIC HEALTH DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LGA COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEMELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-781-4243
Mailing Address - Street 1:2181 JOHNSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401
Mailing Address - Country:US
Mailing Address - Phone:805-781-4243
Mailing Address - Fax:805-781-5541
Practice Address - Street 1:2181 JOHNSON AVE
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401
Practice Address - Country:US
Practice Address - Phone:805-781-4243
Practice Address - Fax:805-781-5541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare