Healthcare Provider Details

I. General information

NPI: 1194743054
Provider Name (Legal Business Name): BLIND & VISUALLY IMPAIRED CENTER OF MONTEREY COUNTY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 LAUREL AVE
PACIFIC GROVE CA
93950-3651
US

IV. Provider business mailing address

225 LAUREL AVE
PACIFIC GROVE CA
93950-3651
US

V. Phone/Fax

Practice location:
  • Phone: 831-649-3505
  • Fax: 831-649-4057
Mailing address:
  • Phone: 831-649-3505
  • Fax: 831-649-4057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number9928
License Number StateCA

VIII. Authorized Official

Name: CHERI PADIN
Title or Position: BUSINESS DIRECTOR
Credential:
Phone: 831-649-3505