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CALIFORNIA RETINA CONSULTANTS NPI 1265575591


NPI Information

NPI: 1265575591
Provider Name: CALIFORNIA RETINA CONSULTANTS
Classification: Ophthalmology - 207WX0107X
Entity Type: Organization

Specialization: Retina Specialist

CLIA Number: 05D2110624

Address:
1510 E MAIN ST
SUITE 103
SANTA MARIA, CA
ZIP 93454
Phone: (805) 922-2068
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CALIFORNIA RETINA CONSULTANTS is a retina specialist ophthalmology in Santa Maria, CA. The provider is an ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. CALIFORNIA RETINA CONSULTANTS NPI is 1265575591. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1510 E MAIN ST
SUITE 103
SANTA MARIA, CA
ZIP 93454-825
Phone: (805) 922-2068

The provider's authorized official is Robert L Avery .
The authorized official title is Ceo and has the following contact phone number (805) 963-1648.

The CLIA number assigned to this NPI record is 05D2110624 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/15/2007 and was last updated on 3/4/2022.


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
1174400000XSpecialistNo
2207WX0107XOphthalmologyRetina SpecialistYes

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
1GR0091151MEDICAIDCALIFORNIA
2ZZZ60752ZOTHERCALIFORNIABLUE SHIELD GROUP #

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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