Healthcare Provider Details

I. General information

NPI: 1194427831
Provider Name (Legal Business Name): OAKEY MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 PACIFICA STE 390
IRVINE CA
92618-3335
US

IV. Provider business mailing address

12 BAYLEAF LN
IRVINE CA
92620-1262
US

V. Phone/Fax

Practice location:
  • Phone: 949-478-4770
  • Fax: 949-239-1043
Mailing address:
  • Phone: 801-865-1793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number
License Number State

VIII. Authorized Official

Name: ZACKERY BECK OAKEY
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MD
Phone: 949-478-4770