Eagle Vision Eye Care Optometric Group

LBN: Eagle Vision Eye Care Optometric Group
Eagle Vision Eye Care Optometric Group is an health care organization with primary practice located at 5777 Greenback Ln. Ste 100, Sacramento CA 95841-2013. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Eagle Vision Eye Care Optometric Group can be contacted via phone (916) 231-0034, or through Johnson, Michael Wayne via phone (916) 231-0034.

Contact Information

Primary practice address
5777 Greenback Ln. Ste 100 Sacramento CA 95841-2013
Phone: (916) 231-0034
Fax: (916) 231-0038
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Michael Wayne Doctor of Optometry (OD)
Phone: (916) 231-0034

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X

Profile Details

NPI number 1174708804
LBN Legal business name Eagle Vision Eye Care Optometric Group
DBA Doing business as
Authorized official Johnson, Michael Wayne Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 31st, 2007
Last updated Aug 29th, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174708804 NPPES
California MEDICAID CT764A

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