County of San Luis Obispo

NPI #1982024956 in Grover Beach, California

Provider Information

NPI Number: 1982024956
Entity Type: Organization
Organization Name: County of San Luis Obispo
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Apr 17, 2014
Last Updated: Apr 29, 2014

Practice Location

Address: 1523 LONGBRANCH AVE
City: Grover Beach
State: California
ZIP Code: 93433-2508
Phone: (805) 473-7080

Authorized Official

Name: M DAISY ILANO, M.D.
Title: MEDICAL DIRECTOR
Phone: (805) 781-4700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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