Healthcare Provider Details

I. General information

NPI: 1033431424
Provider Name (Legal Business Name): JONATHAN SAVELL, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2010
Last Update Date: 03/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 FENTON ST
LIVERMORE CA
94550-4144
US

IV. Provider business mailing address

28 FENTON ST
LIVERMORE CA
94550-4144
US

V. Phone/Fax

Practice location:
  • Phone: 925-449-4000
  • Fax: 925-606-6603
Mailing address:
  • Phone: 925-449-4000
  • Fax: 925-606-6603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number StateCA

VIII. Authorized Official

Name: MRS. IVONNE ROSE WITT
Title or Position: ADMINISTRATOR
Credential:
Phone: 925-460-5000