Abroms Dougherty Vision ASC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ABROMS DOUGHERTY VISION ASC LLC

Practice address

4472 Broad St Ste 150
San Luis Obispo, CA 93401-7990

Phone

(805) 548-1051

NPI assigned

Oct 23, 2020

Last updated

May 12, 2026By 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

Clifton Bazhaw

Title

Chief Revenue Officer

Phone

(214) 893-0471

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Paul J Dougherty M D Inc

  dba DLV Vision Management LLC

  • Ophthalmology Physician
  • Westlake Village, CA
  • NPI 1649203639

  Member Of

  NPD member

Practitioners 2

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.

• Adam D Abroms, MD

  • Ophthalmology Physician
  • Westlake Village, CA
  • NPI 1497743702
  NPD
• Paul J Dougherty, M.D.

  • Ophthalmology Physician
  • Westlake Village, CA
  • NPI 1083744775
  NPD (past)

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778544000000",
    "number": "1790384303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4472 BROAD ST STE 150",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017990",
            "telephone_number": "805-548-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4472 BROAD ST STE 150",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017990",
            "telephone_number": "805-548-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABROMS DOUGHERTY VISION ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-23",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A",
        "authorized_official_last_name": "BAZHAW",
        "authorized_official_first_name": "CLIFTON",
        "authorized_official_title_or_position": "CHIEF REVENUE OFFICER",
        "authorized_official_telephone_number": "214-893-0471"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nisha Abdul Cader, M.D.
• Rushdi Zareen Abdul Cader, MD
• Lant Jarvis Abernathy, DPM
• Able Therapy Services
• Ronnie M Abraham, MD
• Mona Abutouk
• Achilles Prosthetics and Orthotics, Inc
• Laurence Ackerman, DDS
• Adam J. Janette, DDS Inc. (San Luis Oral and Maxillofacial Surgery and Dental Implant Center)
• Caden James Adams

• Ambulatory Surgical Clinic/Center in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.