Organization
ABROMS DOUGHERTY VISION ASC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLIFTON BAZHAW (CHIEF REVENUE OFFICER)
(214) 893-0471
Entity
Organization
Contact information
Practice address
4472 BROAD ST STE 150, SAN LUIS OBISPO, CA 93401-7990
(805) 548-1050
Mailing address
4472 BROAD ST STE 150, SAN LUIS OBISPO, CA 93401-7990
(805) 548-1051
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/23/2020
Last updated
02/05/2026
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