Organization
SAN LUIS OBISPO EYE ASSOCIATES, A MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE MELE (PRACTICE ADMINISTRATOR)
(805) 781-3937
Entity
Organization
Contact information
Practice address
689 TANK FARM RD, SUITE 100, SAN LUIS OBISPO, CA 93401
(805) 781-3937
(805) 781-9013
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
—
CA
207W00000X
Ophthalmology Physician
Primary
—
CA
332B00000X
Durable Medical Equipment & Medical Supplies
—
CA
332H00000X
Eyewear Supplier
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0068240
—
CA
Enumeration date
01/12/2007
Last updated
07/21/2022
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