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MARK WILLIAM WALDMIRE NPI 1154313963


NPI Information

NPI: 1154313963
Provider Name: MARK WILLIAM WALDMIRE
Classification: Optometrist - 152W00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
4633 WHITNEY AVE
SUITE A
SACRAMENTO, CA
ZIP 95821
Phone: (916) 487-1717
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Mark William Waldmire is an optometrist in Sacramento, CA with 31 years of experience. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. Mark William Waldmire NPI is 1154313963. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF CALIFORNIA - SCHOOL OF OPTOMETRY
Graduation Year:1993

The provider's business location address is:

4633 WHITNEY AVE
SUITE A
SACRAMENTO, CA
ZIP 95821-100
Phone: (916) 487-1717
Fax: (916) 487-3081

The NPI 1154313963 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 8/17/2005 and was last updated on 2/23/2015.


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
1152W00000XOptometrist10098TCALIFORNIAYes

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
1U51123MEDICARE UPINCALIFORNIA
2FW154AMEDICARE PINCALIFORNIA
3SD0100980MEDICAIDCALIFORNIA
4FW161ZMEDICARE PIN
53939210001MEDICARE NSCCALIFORNIA
6SD0100980MEDICARE PINCALIFORNIA

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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