| Dr Martin Lee Hetland, OD | |
|
3855 Broad St Ste B, San Luis Obispo, CA 93401-7109 | |
| (805) 545-8100 | |
| Not Available |
| Full Name | Dr Martin Lee Hetland |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | 3855 Broad St Ste B, San Luis Obispo, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851384218 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 9744T (California) | Primary |
| Provider Name | Pacific Eye Surgeons A California Professional Medical Corporation |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1548262751 PECOS PAC ID: 7810947397 Enrollment ID: O20050124000636 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Martin Lee Hetland, OD 3855 Broad St Ste B, San Luis Obispo, CA 93401-7109 Ph: (805) 545-8100 | Dr Martin Lee Hetland, OD 3855 Broad St Ste B, San Luis Obispo, CA 93401-7109 Ph: (805) 545-8100 |
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 |