Individual
DR. JOHN WILLIAM HALLISEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1270 PEACH ST, SAN LUIS OBISPO, CA 93401-2856
(805) 541-1342
(805) 541-5836
Mailing address
1270 PEACH ST, SAN LUIS OBISPO, CA 93401-2856
(805) 541-1342
(805) 541-5836
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G25366
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G253660
—
CA
Enumeration date
01/05/2007
Last updated
07/08/2007
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