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: July 19, 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
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

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.

Optometrist
1245 BROAD ST
SAN LUIS OBISPO, CA 93401
Optometrist
1245 BROAD ST
SAN LUIS OBISPO, CA 93401
Ophthalmology
1245 BROAD ST
SAN LUIS OBISPO, CA 93401

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1871687640, enumerated as an "individual" on October 03, 2006.

The provider is located at 1245 BROAD ST SAN LUIS OBISPO, CA 93401 and the phone number is (805) 542-0700.

Optometrist with taxonomy code 152W00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.