Healthcare Provider Details

I. General information

NPI: 1538443049
Provider Name (Legal Business Name): VISIONCARE OF CALIFORNIA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2011
Last Update Date: 10/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 EL CAMINO REAL STE B3
REDWOOD CITY CA
94063-1692
US

IV. Provider business mailing address

1005 EL CAMINO REAL STE B3
REDWOOD CITY CA
94063-1692
US

V. Phone/Fax

Practice location:
  • Phone: 650-474-2020
  • Fax: 650-474-3600
Mailing address:
  • Phone: 650-474-2020
  • Fax: 650-474-3600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: NICK SHASHTI
Title or Position: PRESIDENT & C.O.O
Credential:
Phone: 800-454-4647