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General NPI Number Information
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NPI Number | 1356110092
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Entity Type | Organization
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Legal Business Name | AESTHETIC EYE CARE
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Dates
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Enumeration Date | 12/21/2023
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 805 AEROVISTA PL STE 109
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-7970
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Country | US
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Telephone | 312-404-7237
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Fax |
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Provider Business Mailing Address
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Address Line | 3964 RIGHETTI RANCH RD
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-6244
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | GINA HELLMAN
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Credential | OD
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Telephone | 312-404-7237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number |
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License Number State |
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