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ELITE EYECARE MEDICAL GROUP A MEDICAL CORPORATION NPI 1245548023


NPI Information

NPI: 1245548023
Provider Name: ELITE EYECARE MEDICAL GROUP A MEDICAL CORPORATION

Doing Business As: SHEPARD EYE CENTER

Classification: Ophthalmology - 207W00000X
Entity Type: Organization
Address:
1429 S BROADWAY
SANTA MARIA, CA
ZIP 93454
Phone: (805) 925-9575
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ELITE EYECARE MEDICAL GROUP A MEDICAL CORPORATION is an ophthalmology in Santa Maria, CA. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. ELITE EYECARE MEDICAL GROUP A MEDICAL CORPORATION NPI is 1245548023. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Shepard Eye Center.

The provider's business location address is:

1429 S BROADWAY
SANTA MARIA, CA
ZIP 93454
Phone: (805) 925-9575
Fax: (805) 347-0033

The provider's authorized official is Kenneth R Kendall .
The authorized official title is Ceo and has the following contact phone number (805) 922-2637.

The enumeration date for this NPI number is 9/15/2010 and was last updated on 10/1/2018.


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
1207W00000XOphthalmologyYes

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
1GR0086921MEDICAIDCALIFORNIA

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: 11/14/2023

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