Provider Demographics
NPI:1851073134
Name:COUNTY OF SAN LUIS OBISPO
Entity Type:Organization
Organization Name:COUNTY OF SAN LUIS OBISPO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SHERIFF'S CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SETH
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:STABINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-781-4510
Mailing Address - Street 1:1585 KANSAS AVE
Mailing Address - Street 2:SHERIFF'S ADMINISTRATION ATTN CMO
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-7604
Mailing Address - Country:US
Mailing Address - Phone:805-781-4510
Mailing Address - Fax:805-781-4646
Practice Address - Street 1:1585 KANSAS AVE
Practice Address - Street 2:SHERIFF'S ADMINISTRATION ATTN CMO
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-7604
Practice Address - Country:US
Practice Address - Phone:805-781-4510
Practice Address - Fax:805-781-4646
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SAN LUIS OBISPO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health