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EMPIRE EYE DOCTORS MEDICAL GROUP INC NPI 1003806068


NPI Information

NPI: 1003806068
Provider Name: EMPIRE EYE DOCTORS MEDICAL GROUP INC
Classification: Ophthalmology - 207W00000X
Entity Type: Organization
Address:
720 4TH ST
SANTA ROSA, CA
ZIP 95404
Phone: (707) 575-3800
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EMPIRE EYE DOCTORS MEDICAL GROUP INC is an ophthalmology in Santa Rosa, 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. EMPIRE EYE DOCTORS MEDICAL GROUP INC NPI is 1003806068. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

720 4TH ST
SANTA ROSA, CA
ZIP 95404-421
Phone: (707) 575-3800
Fax: (707) 528-4967

The provider's authorized official is Penny Dow .
The authorized official title is Billing Manager and has the following contact phone number (707) 575-3800.

The enumeration date for this NPI number is 10/21/2005 and was last updated on 5/1/2008.


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
1152W00000XOptometrist8739TCALIFORNIANo
2152WL0500XOptometristLow Vision Rehabilitation8817TCALIFORNIANo
3207W00000XOphthalmologyG57122CALIFORNIANo
4207W00000XOphthalmologyG32019CALIFORNIANo
5152W00000XOptometristT10471CALIFORNIANo
6207W00000XOphthalmologyG32243CALIFORNIAYes

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
1CP5395OTHERCALIFORNIARAILROAD MEDICARE
21324930001MEDICARE NSCCALIFORNIA
3GR0016130MEDICAIDCALIFORNIA
4ZZZ92901ZMEDICARE PINCALIFORNIA

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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