TINA LISA HECK

SAN LUIS OBISPO, CA
NPI1003048620
Former NameTINA LISA PRAVONGVIENGKHAM
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: CA  PA20461)
Enumeration Date2009-08-14
Last Update Date2015-06-11
Business Address
Mrs. TINA LISA HECK PA-C
77 CASA ST STE 201
SAN LUIS OBISPO, CA 93405-5806
Phone number: 805-269-1500
Mailing Address
Mrs. TINA LISA HECK PA-C
2050 S BLOSSER RD
SANTA MARIA, CA 93458-7310
Phone number: 805-361-8028
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