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Contact Information

GLENN N GRAHAM, OD
1245 BROAD ST
SAN LUIS OBISPO, CA93401
 Phone: 805-542-0700
 Fax: 805-784-9309
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for GLENN N GRAHAM · (Male)

NPI Number 1871687640
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 10/03/2006
Last updated 01/22/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • CA License # 7203T
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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