Organization
SAN LUIS OBISPO EYE ASSOCIATES, A MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINA LYKENS COE (PRACTICE ADMINISTRATOR)
(805) 781-3937
Entity
Organization
Contact information
Practice address
689 TANK FARM RD, SAN LUIS OBISPO, CA 93401-7077
(805) 781-3937
Mailing address
234 HEATHER CT, SUITE 102, TEMPLETON, CA 93465-8765
(805) 434-5970
(805) 434-5973
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1159330001
DMERC REGION D
CA
05
—
GR0068240
—
CA
Enumeration date
11/06/2007
Last updated
10/21/2022
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