Provider Demographics
NPI:1659745974
Name:HP CONTINGENT
Entity Type:Organization
Organization Name:HP CONTINGENT
Other - Org Name:SLO REHABILITATION MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GLEASON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-499-8365
Mailing Address - Street 1:3599 SUELDO ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-7386
Mailing Address - Country:US
Mailing Address - Phone:805-900-0741
Mailing Address - Fax:805-221-6135
Practice Address - Street 1:35 CASA ST
Practice Address - Street 2:SUITE 370
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-1818
Practice Address - Country:US
Practice Address - Phone:805-900-0741
Practice Address - Fax:805-221-6135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108043261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty