Provider Demographics
NPI:1902937667
Name:PARNES, GLENN STERLING (OD)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:STERLING
Last Name:PARNES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 SANTA ROSA ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-2801
Mailing Address - Country:US
Mailing Address - Phone:805-541-2777
Mailing Address - Fax:805-541-2815
Practice Address - Street 1:695 SANTA ROSA ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2801
Practice Address - Country:US
Practice Address - Phone:805-541-2777
Practice Address - Fax:805-541-2815
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 8831 TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
117494OtherEYEMED VISIONCARE
44371OtherDAVIS VISION
CA12250OtherMEDICAL EYE SERVICES
SL17404OtherSPECTERA VISION
FC46827OtherSAFEGUARD VISION
CASD0088311Medicaid
U46329Medicare UPIN
CA12250OtherMEDICAL EYE SERVICES