MANTECA OPTOMETRY NPI 1548339112

NPI Information

NPI: 1548339112
Provider Name: MANTECA OPTOMETRY
Classification: Optometrist - 152WP0200X
Entity Type: Organization

Specialization: Pediatrics

Address:
158 N MAPLE AVE
MANTECA, CA
ZIP 95336
Phone: (209) 239-3504
Get Directions

MANTECA OPTOMETRY is a pediatrics optometrist in Manteca, CA. The provider is optometrists who work in Pediatrics are concerned with the prevention, development, diagnosis, and treatment of visual problems in children. MANTECA OPTOMETRY NPI is 1548339112. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

158 N MAPLE AVE
MANTECA, CA
ZIP 95336-503
Phone: (209) 239-3504
Fax: (209) 239-0741

The provider's authorized official is Leanne Lee .
The authorized official title is Partner and has the following contact phone number (209) 239-3504.

The enumeration date for this NPI number is 11/7/2006 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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	152WP0200X	Optometrist	Pediatrics	12388T	CALIFORNIA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1982704979	OTHER	CALIFORNIA	MY NPI NUMBER

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

NPI Synchronization or Removal

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