Most Relevant Information
Provider Data
| NPI Number: | 1003235904 |
| Provider Name: | LAUREN ELVIRA MIRABDOLLAH N.P. |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | 95000334 |
Most Important Dates
| Enumeration Date: | 04/08/2014 |
| Last Updated: | 08/24/2015 |
Provider Practice Location
77 CASA ST
SUITE 201-204
SAN LUIS OBISPO
CA
934055803
Practice Location Phone/Fax
| Phone: | 8052691500 |
| Fax: | 8052691585 |
Provider Mailing Location
2050 S BLOSSER RD
SANTA MARIA
CA
934587310
Provider Mailing Phone/Fax
| Phone: | 8053618028 |
| Fax: | 8053618097 |