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Organization
PRIMARY EYECARE CENTER, AN OPTOMETRIC PRACTICE
Active
Organization
PRIMARY EYECARE CENTER, AN OPTOMETRIC PRACTICE
Active
Other names
Primary Eyecare Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN SAGE HIDER O.D. (OPTOMETRIST AND PARTNER)
(805) 466-3777
Entity
Organization
Contact information
Practice address
764 SANTA ROSA ST, SAN LUIS OBISPO, CA 93401-2804
(805) 543-1447
(805) 543-4778
Mailing address
764 SANTA ROSA ST, SAN LUIS OBISPO, CA 93401-2804
(805) 543-1447
(805) 543-4778
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CD9792
RAILROAD MEDICARE
CA
05
—
GSD000531
—
CA
Enumeration date
03/22/2007
Last updated
05/25/2012
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