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BRADSHAW OPTOMETRY NPI 1073726022


NPI Information

NPI: 1073726022
Provider Name: BRADSHAW OPTOMETRY
Classification: Preferred Provider Organization - 305R00000X
Entity Type: Organization
Address:
8829 SHELDON RD STE 150
ELK GROVE, CA
ZIP 95624
Phone: (916) 682-5558
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BRADSHAW OPTOMETRY is a preferred provider organization in Elk Grove, CA. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. BRADSHAW OPTOMETRY NPI is 1073726022. The provider is registered as an organization entity type.

The provider's business location address is:

8829 SHELDON RD STE 150
ELK GROVE, CA
ZIP 95624-045
Phone: (916) 682-5558
Fax: (916) 688-5569

The provider's authorized official is Paul K Kim .
The authorized official title is Owner Optometrist and has the following contact phone number (916) 682-5558.

The enumeration date for this NPI number is 5/7/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1305R00000XPreferred Provider Organization10618TCALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
114460OTHERCALIFORNIAMEDICAL EYE SERVICES
219222OTHERCALIFORNIASPECTERA
3EYEMEDOTHERCALIFORNIA118210
4SD0106180MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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