Organization
DUISTERMARS OPTOMETRIC CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGG DUISTERMARS O.D. (PRESIDENT)
(805) 546-1988
Entity
Organization
Contact information
Practice address
628 CALIFORNIA BLVD, STE. C, SAN LUIS OBISPO, CA 93401-2542
(805) 546-1988
Mailing address
628 CALIFORNIA BLVD, STE C, SAN LUIS OBISPO, CA 93401-2547
(805) 546-1988
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11247T
CA
Other
Enumeration date
10/14/2007
Last updated
02/14/2008
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