San Luis Obispo Eye Associates, A Medical Group Inc | |
234 Heather Ct, Suite 102, Templeton, CA 93465-8765 | |
(805) 434-5970 | |
(805) 434-5973 |
Full Name | San Luis Obispo Eye Associates, A Medical Group Inc |
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Type | Facility |
Speciality | Ophthalmology |
Location | 234 Heather Ct, Templeton, California |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366409898 | NPI | - | NPPES |
GR0068240 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Secondary |
Provider Name | Rupert C Chowins |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1750368304 PECOS PAC ID: 5496658015 Enrollment ID: I20051220000638 |
Provider Name | Abraham Suhr |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1114991676 PECOS PAC ID: 7810990751 Enrollment ID: I20060816000138 |
Provider Name | Frank Mark Basich |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1811902257 PECOS PAC ID: 2860577111 Enrollment ID: I20101004000401 |
Provider Name | Rena Artemis Stathacopoulos |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1881609238 PECOS PAC ID: 3678658929 Enrollment ID: I20101011001156 |
Provider Name | Joseph Roy Horne |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1912914482 PECOS PAC ID: 1557553245 Enrollment ID: I20101013000876 |
Provider Name | William J Gealy |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1013922467 PECOS PAC ID: 9133204480 Enrollment ID: I20101015001244 |
Provider Name | Larry Bryan Baldwin |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1205843786 PECOS PAC ID: 6305921651 Enrollment ID: I20101018001115 |
Provider Name | Stephen Scott Bylsma |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1265435325 PECOS PAC ID: 8224088026 Enrollment ID: I20110203000495 |
Provider Name | Marques Bostic |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1265753404 PECOS PAC ID: 3779768742 Enrollment ID: I20191210002912 |
Provider Name | Daniel R Agarwal |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1811230766 PECOS PAC ID: 8820365851 Enrollment ID: I20200729002573 |
Provider Name | David Earl Bowin |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1487271243 PECOS PAC ID: 9739580960 Enrollment ID: I20210625001242 |
Provider Name | Jason Daniel Bunker |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1568133692 PECOS PAC ID: 5092104539 Enrollment ID: I20211122002918 |
Provider Name | Leia Michelle Dumlao Ballesteros |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1205557550 PECOS PAC ID: 4880060953 Enrollment ID: I20221013002669 |
Mailing Address | Practice Location Address |
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San Luis Obispo Eye Associates, A Medical Group Inc 234 Heather Ct, Suite 102, Templeton, CA 93465-8765 Ph: (805) 434-5970 | San Luis Obispo Eye Associates, A Medical Group Inc 234 Heather Ct, Suite 102, Templeton, CA 93465-8765 Ph: (805) 434-5970 |