Doctor Name: | DR. KATHLEEN L LONG |
NPI Number: | 1033177449 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | A23162 |
Business Practice Address: | 1235 Osos St Suite 100 San Luis Obispo, CA - 934013600 |
Business Phone Number: | 8055490888 |
Business Fax Number: | 8055498463 |
Mailing Address: | 1235 Osos St, Suite 100 SAN LUIS OBISPO |
State: | CA |
Postal Code: | 934013600 |
Phone Number: | 8055490888 |
Fax Number: | 8055498463 |
NPI Enumeration Date: | 05/03/2006 |
NPI Last Update Date: | 03/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2080A0000X |
License Number: | A23162 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Pediatrics |
Taxonomy Specialization: | Adolescent Medicine |
Taxonomy Definition: | A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |