Individual
DR. DEREK L COOMBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
592 CALIFORNIA BLVD, SAN LUIS OBISPO, CA 93405-1900
(805) 543-4777
(805) 543-4886
Mailing address
1653 16TH ST, LOS OSOS, CA 93402-1820
(805) 528-6243
(805) 543-4886
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT 7166 TPA
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0071660
—
CA
Enumeration date
08/10/2006
Last updated
07/09/2007
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