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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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