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RETINA SPECIALISTS OF THE CENTRAL COAST INC NPI 1821271248


NPI Information

NPI: 1821271248
Provider Name: RETINA SPECIALISTS OF THE CENTRAL COAST INC
Classification: Ophthalmology - 207W00000X
Entity Type: Organization
Address:
628 CALIFORNIA BLVD
SUITE C
SAN LUIS OBISPO, CA
ZIP 93401
Phone: (805) 547-2090
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RETINA SPECIALISTS OF THE CENTRAL COAST INC is an ophthalmology in San Luis Obispo, CA. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. RETINA SPECIALISTS OF THE CENTRAL COAST INC NPI is 1821271248. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

628 CALIFORNIA BLVD
SUITE C
SAN LUIS OBISPO, CA
ZIP 93401-542
Phone: (805) 547-2090
Fax: (805) 547-2095

The provider's authorized official is Derek B. Lauritzen .
The authorized official title is President and has the following contact phone number (805) 547-2090.

The enumeration date for this NPI number is 12/7/2007 and was last updated on 11/18/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207W00000XOphthalmologyC3049777CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1C3049777OTHERCALIFORNIACA STATE LICENSE
2ZZZ50256YOTHERCALIFORNIABLUE SHIELD OF CALIFORNIA
3613177600OTHEROWCP
4W21609MEDICARE PIN
5DG9149MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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