Provider Type Icon

LAS TABLAS MEDICAL GROUPINC NPI 1205994977


NPI Information

NPI: 1205994977
Provider Name: LAS TABLAS MEDICAL GROUP,INC

Doing Business As: LAS TABLAS MEDICAL GROUP

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D0587284

Address:
2120 GOLDEN HILL RD
SUITE 102
PASO ROBLES, CA
ZIP 93446
Phone: (805) 434-2900
Get Directions

LAS TABLAS MEDICAL GROUP,INC is a family medicine in Paso Robles, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. LAS TABLAS MEDICAL GROUP,INC NPI is 1205994977. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Las Tablas Medical Group.

The provider's business location address is:

2120 GOLDEN HILL RD
SUITE 102
PASO ROBLES, CA
ZIP 93446-047
Phone: (805) 434-2900
Fax: (805) 434-2928

The provider's authorized official is Norma J Smith .
The authorized official title is Office Manager and has the following contact phone number (805) 434-2900.

The CLIA number assigned to this NPI record is 05D0587284 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/5/2006 and was last updated on 2/7/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine=========CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1A46879MEDICARE UPINCALIFORNIA
2W20497OTHERCALIFORNIAPTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.