Healthcare Provider Details

I. General information

NPI: 1376402875
Provider Name (Legal Business Name): ECS OF BAY AREA II OPTOMETRY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8694 ELK GROVE BLVD STE 7
ELK GROVE CA
95624-1753
US

IV. Provider business mailing address

PO BOX 739973
DALLAS TX
75373-9973
US

V. Phone/Fax

Practice location:
  • Phone: 916-685-3369
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: MELISSA ALLISON
Title or Position: SR. DIRECTOR MVC
Credential:
Phone: 618-604-5208