EYE ASSOCIATES OF SEBASTOPOL MEDICAL GROUP NPI 1598800419

NPI Information

NPI: 1598800419
Provider Name: EYE ASSOCIATES OF SEBASTOPOL MEDICAL GROUP
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization

CLIA Number: 05D1077728

Address:
6574 OAKMONT DR STE A
SANTA ROSA, CA
ZIP 95409
Phone: (707) 579-2020
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EYE ASSOCIATES OF SEBASTOPOL MEDICAL GROUP is an eyewear supplier in Santa Rosa, CA. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. EYE ASSOCIATES OF SEBASTOPOL MEDICAL GROUP NPI is 1598800419. The provider is registered as an organization entity type.

The provider's business location address is:

6574 OAKMONT DR STE A
SANTA ROSA, CA
ZIP 95409-958
Phone: (707) 579-2020
Fax: (707) 539-6183

The provider's authorized official is Cathy A Udell .
The authorized official title is Credentialling and has the following contact phone number (707) 823-7628.

The CLIA number assigned to this NPI record is 05D1077728 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 2/20/2007 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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332H00000X	Eyewear Supplier				Yes

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: 5/5/2024

NPI Synchronization or Removal

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