Basic Information
Provider Information
NPI: 1346546363
EntityType: 2
ReplacementNPI:  
OrganizationName: HOSPITALIST MEDICINE PHYSICIANS OF SAN LUIS OBISPO COUNTY, INC
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Mailing Information
Address1: 4535 DRESSLER RD NW
Address2:  
City: CANTON
State: OH
PostalCode: 447182545
CountryCode: US
TelephoneNumber: 3304934443
FaxNumber: 3304938677
Practice Location
Address1: 1100 LAS TABLAS RD
Address2:  
City: TEMPLETON
State: CA
PostalCode: 934659704
CountryCode: US
TelephoneNumber: 3304934443
FaxNumber: 3304938677
Other Information
ProviderEnumerationDate: 02/09/2011
LastUpdateDate: 02/09/2011
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: HOUFF
AuthorizedOfficialFirstName: STEPHEN
AuthorizedOfficialMiddleName: L
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 3304934443
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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