Healthcare Provider Details
I. General information
NPI: 1912667486
Provider Name (Legal Business Name): JOHANN J. SCHLAGER, OD INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/27/2021
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
394 E YOSEMITE AVE STE 100
MERCED CA
95340-8218
US
IV. Provider business mailing address
394 E YOSEMITE AVE STE 100
MERCED CA
95340-8218
US
V. Phone/Fax
- Phone: 93-830-2582
- Fax: 209-383-0258
- Phone: 209-383-1246
- Fax: 209-383-0258
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WC0802X |
| Taxonomy | Corneal and Contact Management Optometrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WV0400X |
| Taxonomy | Vision Therapy Optometrist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHANN
JOSUE
SCHLAGER
Title or Position: PRESIDENT/OWNER
Credential: OD
Phone: 310-483-6282