NPIMap

Organization Active NPI

San Luis Obispo Rehabilitation Specialists, Inc.

  • Physical Medicine & Rehabilitation Physician
  • San Luis Obispo, CA
National Provider Identifier
1073645909
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
G66332 Issued in CA
Legal business name
SAN LUIS OBISPO REHABILITATION SPECIALISTS, INC.
Practice address
865 Aerovista PL
Suite 120
San Luis Obispo, CA 93401-7901
Phone
(805) 543-5908
Fax
(805) 543-3063
NPI assigned
Mar 9, 2007
Last updated
Sep 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joseph B. Griffin, M.D.NPI 1992799399
Title
President
Phone
(805) 543-5908

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X G66332 CA Primary

Addresses

Primary practice location

865 Aerovista PL
Suite 120
San Luis Obispo, CA 93401-7901

Mailing address

793 E Foothill Blvd Ste a
PMB #135
San Luis Obispo, CA 93405-1699
Phone (805) 543-5908

Other identifiers 2

IdentifierTypeStateIssuer
GR0088830MedicaidCA
ZZZ61463ZOtherCABLUE SHIELD GROUP PIN

National Provider Directory

National Provider Directory

Locations

793 E Foothill Blvd
San Luis Obispo, CA 93405

100 Casa St
Ste A2
Sn Luis Obisp, CA 93405
Phone (805) 543-5908

865 Aerovista Pl
Ste 120
Sn Luis Obisp, CA 93401
Phone (805) 459-2508

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316476800000",
    "number": "1073645909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 E FOOTHILL BLVD STE A",
            "address_2": "PMB #135",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051699",
            "telephone_number": "805-543-5908",
            "fax_number": "805-543-3063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 AEROVISTA PL",
            "address_2": "SUITE 120",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017901",
            "telephone_number": "805-543-5908",
            "fax_number": "805-543-3063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN LUIS OBISPO REHABILITATION SPECIALISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2011-09-20",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-543-5908",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "G66332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0088830",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP PIN",
            "identifier": "ZZZ61463Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.