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APPLE VALLEY FAMILY OPTOMETRY CENTRE NPI 1891826210


NPI Information

NPI: 1891826210
Provider Name: APPLE VALLEY FAMILY OPTOMETRY CENTRE
Classification: Optometrist - 152W00000X
Entity Type: Organization

CLIA Number: 05D2268262

Address:
15972 TUSCOLA RD
SUITE 101
APPLE VALLEY, CA
ZIP 92307
Phone: (760) 946-2700
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APPLE VALLEY FAMILY OPTOMETRY CENTRE is an optometrist in Apple Valley, CA. 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. APPLE VALLEY FAMILY OPTOMETRY CENTRE NPI is 1891826210. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

15972 TUSCOLA RD
SUITE 101
APPLE VALLEY, CA
ZIP 92307-106
Phone: (760) 946-2700
Fax: (760) 946-3355

The provider's authorized official is Steven Bruce Wallis .
The authorized official title is Doctor and has the following contact phone number (760) 946-2700.

The CLIA number assigned to this NPI record is 05D2268262 - other - government employment with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/8/2007 and was last updated on 8/6/2009.


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
1152W00000XOptometrist7082TCALIFORNIAYes

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
1ZZZ05917ZOTHERCALIFORNIAMEDICARE PTAN
21083820001MEDICARE NSCCALIFORNIA
3=========OTHERCALIFORNIAUNITED HEALTH CARE
4U16506MEDICARE UPINCALIFORNIA
5=========OTHERCALIFORNIAWPS TRICARE
6SD0070820MEDICAIDCALIFORNIA
7ZZZ58328ZOTHERCALIFORNIABLUE SHIELD
8=========OTHERCALIFORNIABLUE CROSS

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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