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PAUL C BRUDERER O D P C NPI 1427241843


NPI Information

NPI: 1427241843
Provider Name: PAUL C BRUDERER O D P C

Doing Business As: WEST VALLEY VISION SOURCE

Classification: Optometrist - 152W00000X
Entity Type: Organization
Address:
2782 S 5600 W STE 101
WEST VALLEY CITY, UT
ZIP 84120
Phone: (801) 969-9999
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PAUL C BRUDERER O D P C is an optometrist in West Valley City, UT. 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. PAUL C BRUDERER O D P C NPI is 1427241843. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As West Valley Vision Source.

The provider's business location address is:

2782 S 5600 W STE 101
WEST VALLEY CITY, UT
ZIP 84120-592
Phone: (801) 969-9999
Fax: (801) 746-1007

The provider's authorized official is Paul Christian Bruderer .
The authorized official title is Owner and has the following contact phone number (801) 969-9999.

The enumeration date for this NPI number is 8/20/2007 and was last updated on 2/4/2022.


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
1152W00000XOptometrist4942085-9934UTAHYes

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
1291777OTHERALTIUS
249420859901OTHERBLUE CROSS BLUE SHIELD
3788511OTHERDESERET MUTUAL
42157848OTHERFIRST HEALTH
5528558921001MEDICAIDUTAH
6IDX5199969OTHERUTAHUNIVERSITY HEALTH CARE
75510561OTHERCCN
8TPRA08151OTHERUTAHMOLINA HEALTHCARE
97664549OTHERAETNA
1081648OTHERPEHP

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.