Sierra Vista Medical Pavilion Ambulatory Surgery Suite

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

G42294 Issued in CA

Legal business name

SIERRA VISTA MEDICAL PAVILION AMBULATORY SURGERY SUITE

Practice address

77 Casa Street
Ste 203
San Luis Obispo, CA 93405

Phone

(805) 544-6471

Fax

(805) 544-4913

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Mr. James Thornton, MD

Title

Physician Owner

Phone

(805) 544-6471

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Frederick Haseman, MD

  • Specialist
  • San Luis Obispo, CA
  • NPI 1114043320
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1952443046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 CASA STREET",
            "address_2": "STE 203",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93405",
            "telephone_number": "805-544-6471",
            "fax_number": "805-544-4913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 CASA STREET",
            "address_2": "STE 203",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93405",
            "telephone_number": "805-544-6471",
            "fax_number": "805-544-4913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA VISTA MEDICAL PAVILION AMBULATORY SURGERY SUITE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "THORNTON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "805-544-6471",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "G42294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1750380374",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lawrence Zachary Siegler, MFT
• Sierra Mental Wellness
• Sierra Mental Wellness Group
• Sierra Vista Hospital, Inc. (Sierra Vista Regional Medical Center)
• Sierra Vista Hospital, Inc. (Sierra Vista Regional Medical Center)
• Kahlua Sievert
• Monique N Sigler
• Alexa Renee Signore
• Victor Silva-Palacios, PHD
• Olivia Marie Silva, B.A. PSYCHOLOGY

• Ambulatory Surgical Clinic/Center in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.