ABROMS DOUGHERTY VISION ASC LLC; NPI #1790384303

Contact Information

ABROMS DOUGHERTY VISION ASC LLC

4472 BROAD ST STE 150
SAN LUIS OBISPO, CA 93401-7990

Phone: 805-548-1051
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Ambulatory Surgical	261QA1903X	49	Ambulatory Surgical Center

Indicates primary specialty

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NPI Profile & details for ABROMS DOUGHERTY VISION ASC LLC

NPI #	`1790384303`
LBN Legal business name	ABROMS DOUGHERTY VISION ASC LLC
Authorized official	CLIFTON BAZHAW - (CHIEF REVENUE OFFICER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	10/23/2020
Last updated	05/12/2026 - About a month ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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