Organization
CENTRAL COAST EYE ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLEN F OEKLER MD (PRESIDENT)
(805) 544-0102
Entity
Organization
Contact information
Practice address
628 CALIFORNIA BLVD, STE C, SAN LUIS OBISPO, CA 93401
(805) 544-0102
(805) 546-2445
Mailing address
628 CALIFORNIA BLVD, STE C, SAN LUIS OBISPO, CA 93401
(805) 544-0102
(805) 546-2445
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0026760
—
CA
05
—
GR0026761
—
CA
Enumeration date
08/04/2006
Last updated
10/17/2007
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