| B Jeffrey Blue Od And Jason Chang Od Inc | |
|
1245 Broad St, San Luis Obispo, CA 93401-3907 | |
| (805) 542-0700 | |
| (805) 784-9309 |
| Full Name | B Jeffrey Blue Od And Jason Chang Od Inc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 1245 Broad St, San Luis Obispo, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427291897 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 7135 (* (Not Available)) | Primary |
| 152WL0500X | Optometrist - Low Vision Rehabilitation | 13148 (California) | Secondary |
| Provider Name | Bryce J Blue |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548387590 PECOS PAC ID: 5294780656 Enrollment ID: I20050317001055 |
| Provider Name | Jason D Chang |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558400663 PECOS PAC ID: 8729160056 Enrollment ID: I20080125000364 |
| Provider Name | Krista M Martin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1336242254 PECOS PAC ID: 7113269135 Enrollment ID: I20190423001582 |
| Provider Name | John Jacob Krochmal |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1942824503 PECOS PAC ID: 3274959382 Enrollment ID: I20200820000664 |
| Mailing Address | Practice Location Address |
|---|---|
| B Jeffrey Blue Od And Jason Chang Od Inc 1245 Broad St, San Luis Obispo, CA 93401-3907 Ph: (805) 542-0700 | B Jeffrey Blue Od And Jason Chang Od Inc 1245 Broad St, San Luis Obispo, CA 93401-3907 Ph: (805) 542-0700 |
Primary Eyecare Center, An Optometric Practice Optometrist Medicare: Medicare Enrolled Practice Location: 764 Santa Rosa St, San Luis Obispo, CA 93401 Phone: 805-543-1447 Fax: 805-543-4778 | |
Dr. Robert B Dirksen, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3855 Broad Street, Suite B, San Luis Obispo, CA 93401 Phone: 805-545-7881 Fax: 805-548-8785 | |
Dr. Scot Anthony Class, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3855 Broad Street, Ste B, San Luis Obispo, CA 93401 Phone: 805-545-8100 Fax: 805-548-8785 | |
Mariah Sibal, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 11990 Los Osos Valley Rd, San Luis Obispo, CA 93405 Phone: 805-858-9914 Fax: 805-316-4113 | |
Kimberly D Johnson, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 628 California Blvd, Ste D, San Luis Obispo, CA 93401 Phone: 805-545-7881 Fax: 805-548-8785 | |
Dr. Charles Lee Tribbey, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 719 Higuera St, San Luis Obispo, CA 93401 Phone: 805-541-2333 Fax: 805-543-5795 | |
Elite Eyecare Medical Group A Medical Corporation Optometrist Medicare: Not Enrolled in Medicare Practice Location: 689 Tank Farm Rd Ste 100, San Luis Obispo, CA 93401 Phone: 805-781-3937 |