Provider Demographics
NPI:1407616402
Name:SAN LUIS OBISPO COUNTY COMMUNITY COLLEGE DISTRICT
Entity Type:Organization
Organization Name:SAN LUIS OBISPO COUNTY COMMUNITY COLLEGE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP ADMINSTRATIVE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-546-3120
Mailing Address - Street 1:PO BOX 8106
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93403-8106
Mailing Address - Country:US
Mailing Address - Phone:805-546-3171
Mailing Address - Fax:180-554-6322
Practice Address - Street 1:HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405
Practice Address - Country:US
Practice Address - Phone:805-546-3171
Practice Address - Fax:180-554-6322
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAN LUIS OBISPO COUNTY COMMUNITY COLLEGE DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
No251300000XAgenciesLocal Education Agency (LEA)