# SAN LUIS OBISPO EYE ASSOCIATES, A MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366409898
- **Authorized official:** LARRY BALDWIN MD (OWNER)
- **Authorized official phone:** (805) 434-5970

## Contact information

- **Practice address:** 234 HEATHER CT, SUITE 102, TEMPLETON, CA 93465-8765
- **Practice address phone:** (805) 434-5970
- **Practice address fax:** (805) 434-5973
- **Mailing address:** 234 HEATHER CT, SUITE 102, TEMPLETON, CA 93465-8765
- **Mailing address phone:** (805) 434-5970
- **Mailing address fax:** (805) 434-5973

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 332H00000X | Eyewear Supplier | — | NULL | — |

## Other

- **Enumeration date:** 04/27/2006
- **Last updated:** 07/22/2022