| Ken P Optometry Corp | |
|
911 Oak Park Blvd, Suite 104, Pismo Beach, CA 93449-3405 | |
| (805) 473-9393 | |
| (805) 473-1974 |
| Full Name | Ken P Optometry Corp |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 911 Oak Park Blvd, Pismo Beach, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497133011 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Kenneth A Peterson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1871565788 PECOS PAC ID: 6204736283 Enrollment ID: I20040113000703 |
| Mailing Address | Practice Location Address |
|---|---|
| Ken P Optometry Corp 911 Oak Park Blvd, Suite 104, Pismo Beach, CA 93449-3405 Ph: (805) 473-9393 | Ken P Optometry Corp 911 Oak Park Blvd, Suite 104, Pismo Beach, CA 93449-3405 Ph: (805) 473-9393 |
Scott Eric Schachter, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 300 James Way, Suite 210, Pismo Beach, CA 93449 Phone: 805-773-6000 Fax: 805-773-2120 | |
Dr. Mona Kaur Gill, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 300 James Way Ste 210, Pismo Beach, CA 93449 Phone: 805-773-6000 Fax: 805-773-2120 | |
Dr. Dennis Raoul Richardson, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 573 Five Cities Dr, Pismo Beach, CA 93449 Phone: 805-773-4700 Fax: 323-296-1062 | |
Michael E. Jacobs, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 573 Five Cities Dr, Pismo Beach, CA 93449 Phone: 805-773-4700 Fax: 805-773-4248 | |
Dr. Kenneth A Peterson, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 911 Oak Park Blvd Ste 104, Pismo Beach, CA 93449 Phone: 805-473-9393 Fax: 805-473-1974 | |
Mona Gill O D Corp Optometrist Medicare: Medicare Enrolled Practice Location: 300 James Way Ste 210, Pismo Beach, CA 93449 Phone: 805-773-6000 Fax: 805-773-2120 |