Healthcare Provider Details

I. General information

NPI: 1225707334
Provider Name (Legal Business Name): CALIFORNIA LASIK & EYE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2021
Last Update Date: 09/20/2021
Certification Date: 09/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 EXPOSITION BLVD
SACRAMENTO CA
95815-4314
US

IV. Provider business mailing address

3278 SOUTHERLAND RD
WEST SACRAMENTO CA
95691-6212
US

V. Phone/Fax

Practice location:
  • Phone: 916-957-1515
  • Fax: 916-957-1567
Mailing address:
  • Phone: 916-957-1515
  • Fax: 916-957-1567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BRADLEY POWERS BARNETT
Title or Position: FOUNDER / MEDICAL DIRECTOR
Credential: MD PHD
Phone: 916-957-1515