Duistermars Optometric Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

11247T Issued in CA

Legal business name

DUISTERMARS OPTOMETRIC CORPORATION

Practice address

628 California Blvd
Ste. C
San Luis Obispo, CA 93401-2542

Phone

(805) 546-1988

NPI assigned

Oct 14, 2007

Last updated

Feb 14, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Gregg Duistermars, O.D.NPI 1376696427

Title

President

Phone

(805) 546-1988

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gregg Duistermars, O.D.

  • Optometrist
  • Granbury, TX
  • NPI 1376696427
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202947200000",
    "number": "1508054685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 CALIFORNIA BLVD",
            "address_2": "STE C",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012547",
            "telephone_number": "805-546-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 CALIFORNIA BLVD",
            "address_2": "STE. C",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012542",
            "telephone_number": "805-546-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUISTERMARS OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-14",
        "last_updated": "2008-02-14",
        "status": "A",
        "authorized_official_last_name": "DUISTERMARS",
        "authorized_official_first_name": "GREGG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-546-1988",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11247T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Duda
• Alicia Dueck, LCSW
• Deborah Dueck, PSYD
• Matthew P Duffy, RADT
• Philippe Duhaime, M.D
• Dominique Duke
• Elizabeth G Duldulao
• Danielle Williams Dumani
• Lorelei Sherry Ho Dumaplin, RN, PMHNP-BC
• Eric William Dunlop, DO

• Optometrist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.