| Organization Name: | SAN LUIS OBISPO CA ENDOSCOPY ASC LP |
| NPI Number: | 1184699241 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHILLIP A CLENDENIN (PRESIDENT) |
| Mailing Address: | 1320 Las Tablas Rd Suite A Templeton |
| State: | CA US |
| Postal Code: | 934659711 |
| Phone Number: | 8054349950 |
| Fax Number: | 8054349952 |
| NPI Enumeration Date: | 02/22/2006 |
| NPI Last Update Date: | 04/17/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 050000582 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |