Organization · Type 2 NPI

Lags Spine and Sportscare Medical Centers, Inc.

Addiction Medicine (Psychiatry & Neurology) Physician · San Luis Obispo, CA

NPI number 1174087274 Active

Practice location

1223 Higuera St Ste 101
San Luis Obispo, CA 93401-3167

Fax (805) 541-8584

Mailing address

218 N I St
Lompoc, CA 93436-0909

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Psychologist 103TA0400XNone listed
Clinical Social Worker 1041C0700XNone listed
Psychiatric/Mental Health Registered Nurse 163WP0808XNone listed
Addiction Medicine (Psychiatry & Neurology) Physician Primary 2084A0401XNone listed

Addiction Medicine (Psychiatry & Neurology) Physician: A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine

3 other providers at this address

About NPI 1174087274

Lags Spine and Sportscare Medical Centers, Inc.'s National Provider Identifier is 1174087274, issued on Jan 23, 2019. The primary taxonomy on file is Addiction Medicine (Psychiatry & Neurology) Physician (2084A0401X), and the practice location is in San Luis Obispo, CA. The record was last updated on Jan 23, 2019.