Healthcare Provider Details

I. General information

NPI: 1952451908
Provider Name (Legal Business Name): ASSOCIATED CHICO EYE SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 04/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 DECLARATION DR SUITE 100
CHICO CA
95973-4902
US

IV. Provider business mailing address

85 DECLARATION DR SUITE 100
CHICO CA
95973-4902
US

V. Phone/Fax

Practice location:
  • Phone: 530-895-3884
  • Fax: 530-343-3030
Mailing address:
  • Phone: 530-895-3884
  • Fax: 530-343-3030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA22457
License Number StateCA

VIII. Authorized Official

Name: DR. ROBERT DUDLEY STONE
Title or Position: OWNER
Credential: M.D.
Phone: 530-895-3884