Ken P Optometry Corp
NPI #1497133011 in Pismo Beach, California
Provider Information
- NPI Number
- 1497133011
- Entity Type
- Organization
- Organization Name
- Ken P Optometry Corp
- Primary Specialty
- Optometrist
- Enumeration Date
- May 14, 2015
- Last Updated
- May 14, 2015
Practice Location
- Address
- 911 OAK PARK BLVD
- Address 2
- SUITE 104
- City
- Pismo Beach
- State
- California
- ZIP Code
- 93449-3405
- Phone
- (805) 473-9393
Authorized Official
- Name
- DR. KENNETH A PETERSON, O. D.
- Title
- OWNER/OPTOMETRIST
- Phone
- (805) 473-9393
Specialties & Taxonomy Codes
| Specialty |
|---|
| Optometrist |
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