CAL POLY HEALTH SERVICES (NPI# 1720140288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720140288 |
| Entity Type | Organization |
| Organization Name | CAL POLY HEALTH SERVICES |
| Practice Address |
Health Services California Polytechnic State University San Luis Obispo CA 93407-0210 |
| Mailing Address |
Cal Poly Health Services 1 Grand Ave San Luis Obispo CA 93407 |
| Practice Telephone | 8057561211 |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2008-07-16 |
| Authorized Official Name | MARTIN BRAGG (DIRECTOR) |
| Authorized Official Telephone | 8057561211 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS1000X |
Clinic/Center Specialization: Student Health |
RN 348161 | CA | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447435912 | Cal Poly Health Services | Clinic/Center | 1 Grand Ave Building 27, Cal Poly State University, San Luis Obispo, CA 93407-0000 | 2008-01-03 |
| Street Address |
HEALTH SERVICES CALIFORNIA POLYTECHNIC STATE UNIVERSITY |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93407-0210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750450680 | David Lloyd Harris | Internal Medicine | Health Services, California Polytechnic State University, San Luis Obispo, CA 93407-0210 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730244377 | Marilyn Jane Pieters | Nurse Practitioner | Cal Poly State University Student Health Services, San Luis Obispo, CA 93407 | 2006-12-26 |
| 1750442653 | California Polytechnic State University At San Luis Obispo | Clinic/Center | Cal Poly Health Services, Grand Ave., San Luis Obispo, CA 93407 | 2006-12-13 |
| 1710065461 | Marina E Perez | Nurse Practitioner | 1 Grand Ave., Cal Poly Health Services, San Luis Obispo, CA 93407 | 2006-11-01 |
| 1447435912 | Cal Poly Health Services | Clinic/Center | 1 Grand Ave Building 27, Cal Poly State University, San Luis Obispo, CA 93407-0000 | 2008-01-03 |
| 1275739245 | Nancy J Walden | Nurse Practitioner | Cal Poly State Health Center, 1 Grand Ave Building 27, San Luis Obispo, CA 93407-0210 | 2007-06-26 |
| 1558475699 | Mark Mason Haley | Physician Assistant | One Grand Ave, San Luis Obispo, CA 93407-0210 | 2006-08-18 |
| 1093946287 | Kevin Mccarthy | General Practice | 1 Grand Ave, San Luis Obispo, CA 93407-0210 | 2009-08-05 |
| 1417194408 | Norman Brooks Smith | Family Medicine | 1 Grand Ave., Cal Poly Health Services, San Luis Obispo, CA 93407-0210 | 2009-01-13 |
| 1326192816 | Gregory W. Thomas | Family Medicine | 1 Grand Ave, California Polytechnic State University San Luis Obispo, San Luis Obispo, CA 93407-0210 | 2007-01-22 |
| 1659450633 | Lorraine M. Berg | Registered Nurse | 1 Grand Ave, Cal Poly Health Services, San Luis Obispo, CA 93407-0210 | 2006-11-02 |
| Find all providers in zip 93407 | ||||
| Taxonomy Code | 261QS1000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Student Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437756103 | Wonderful Center for Health Innovation Inc | Clinic/Center | 14848 Lamberson Ave, Lost Hills, CA 93249 | 2020-10-06 |
| 1811452493 | Wonderful Center for Health Innovation Inc | Clinic/Center | 2070 Veneto St, Delano, CA 93215-9122 | 2019-02-07 |
| 1386134815 | Ventura County Community College District | Clinic/Center | 4667 Telegraph Road, Ventura, CA 93003-3872 | 2018-05-10 |
| 1104339761 | Kern Community College District | Clinic/Center | 1801 Panorama Dr, Bakersfield, CA 93305-1219 | 2017-11-06 |
| 1104342393 | Yosemite Community College District | Clinic/Center | 11600 Columbia College Dr, Sonora, CA 95370-8560 | 2017-08-18 |
| 1750813663 | Yosemite Community College District | Clinic/Center | 435 College Ave, Modesto, CA 95350-5808 | 2017-03-30 |
| 1275937682 | Emmons Student Wellness Center | Clinic/Center | 1600 Campus Rd # F-57, Emmons Wellness Center, Los Angeles, CA 90041-3314 | 2014-10-14 |
| 1083036495 | Nora Anderson | Clinic/Center | 1603 Merion Way, 42 G, Seal Beach, CA 90740-4984 | 2014-01-21 |
| 1386082766 | Esteban E. Torres High School Clinic | Clinic/Center | 4127 East Cesar Chavez Avenue, Los Angeles, CA 90063 | 2013-06-07 |
| 1770920787 | Allan Hancock College | Clinic/Center | 800 S College Dr, Santa Maria, CA 93454-6399 | 2013-05-30 |
| Find all providers with the same taxonomy | ||||
| City | SAN LUIS OBISPO |
| Zip Code | 93407 |
Please comment or provide details below to improve the information on CAL POLY HEALTH SERVICES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.