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DR. GLENN NICOLAS GRAHAM OD
NPI 1871687640
Optometrist in San Luis Obispo, CA

Active since October 03, 2006
1245 BROAD ST, SAN LUIS OBISPO, CA 93401(805) 542-0700(805) 784-9309 Get Directions Write a Review

NPPES record last updated: January 22, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Glenn Nicolas Graham Od NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GLENN NICOLAS GRAHAM OD (NPI 1871687640) is an individual optometrist in San Luis Obispo, California, licensed in California (7203T) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1871687640
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. GLENN NICOLAS GRAHAMCredential: OD
Location Address1245 BROAD STSan Luis Obispo, CA 93401
Mailing Address1245 Broad StSan Luis Obispo, CA 93401 · (805) 542-0700 · Fax (805) 784-9309
Phone(805) 542-0700
Fax(805) 784-9309
Sole ProprietorNo
Enumeration DateOctober 3, 2006
Last NPPES UpdateJanuary 22, 2014
✔ NPI 1871687640 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in CA · 7203T
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
1245 BROAD ST, San Luis Obispo, CA 93401
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Other Identifiers 3

Medicare PINCE549ZCA
Medicare UPINU29801
Medicare ID-Type UnspecifiedWY146CA

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

B JEFFREY BLUE OD AND JASON CHANG OD INC
Optometrist
1245 BROAD ST
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 542-0700
DR. BRYCE JEFFREY BLUE O.D.
Optometrist
1245 BROAD ST
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 542-0700
ELITE EYECARE MEDICAL GROUP A MEDICAL CORPORATION
Ophthalmology
1245 BROAD ST
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 542-0700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glenn Graham's NPI number?

The NPI number for Glenn Graham is 1871687640. It was assigned to this individual provider in the NPPES registry on October 3, 2006.

Where is Glenn Graham located?

Glenn Graham practices at 1245 Broad St, San Luis Obispo, CA 93401. The listed phone number is (805) 542-0700.

What is Glenn Graham's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

When was this NPI record last updated?

The NPPES record for Glenn Graham was last updated on January 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.