Organization
SAN LUIS OBISPO EYE ASSOCIATES, A MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY BALDWIN MD (OWNER)
(805) 434-5970
Entity
Organization
Contact information
Practice address
234 HEATHER CT, SUITE 102, TEMPLETON, CA 93465-8765
(805) 434-5970
(805) 434-5973
Mailing address
234 HEATHER CT, SUITE 102, TEMPLETON, CA 93465-8765
(805) 434-5970
(805) 434-5973
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0068240
—
CA
Enumeration date
04/27/2006
Last updated
07/22/2022
Update your record
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