Okimoto, Mary M

Okimoto, Mary M is an individual health care provider with primary practice located at 715 Tank Farm Road Suite C, San Luis Obispo CA 93401-7068. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Oncology, Pediatrics, which is considered as her primary health care specialty. Okimoto, Mary M can be contacted via phone (805) 543-5577.

Contact Information

Primary practice address
715 Tank Farm Road Suite C San Luis Obispo CA 93401-7068
Phone: (805) 543-5577
Fax: (805) 595-3231
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Oncology, Pediatrics 364SX0204X 17444 California

Profile Details

NPI number 1144400771
LBN Legal business name Okimoto, Mary M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 12th, 2007
Last updated Dec 26th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144400771 NPPES
California Other CB242811 MEDICARE ID

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