Stephen J Tidik M.D.

NPI 1053306803 - Specialist - 174400000X

NPI Details
NPI 1053306803
Gender Male
Enumeration Date 09/19/2005
Last Updated 06/17/2008
Entity Type Individual
Active Over 11 years ago
Practice Location
77 CASA ST
SUITE 103
SAN LUIS OBISPO CA, 93405-5803, US
Phone (805) 544-8993
Fax (805) 544-0120
Business Location
77 CASA ST
SUITE 103
SAN LUIS OBISPO CA, 93405-5803, US
Phone (805) 544-8993
Fax (805) 544-0120
Toxanomy
Taxonomy Code 174400000X
License State California
License Number G57086
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According to our database, Dr. Stephen J Tidik M.D. NPI is 1053306803, taxonomy code is 174400000X and license number is G57086, license state is located at California. Stephen J Tidik M.D. physically located at 77 Casa St, San Luis Obispo CA, 93405-5803. NPI Number Stephen J Tidik M.D. has the Individual type.

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1053306803 NPI number is provided on an as is basis without warranty of any kind. 1053306803 is maintained by the National Plan & Provider Enumeration System. The contents of Stephen J Tidik M.D. are for informational purposes only.