Healthcare Provider Details

I. General information

NPI: 1386738722
Provider Name (Legal Business Name): CAREY VISION MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 FOREST AVE SUITE B
SAN JOSE CA
95128-1469
US

IV. Provider business mailing address

2110 FOREST AVE SUITE B
SAN JOSE CA
95128-1469
US

V. Phone/Fax

Practice location:
  • Phone: 408-295-3433
  • Fax: 408-293-4872
Mailing address:
  • Phone: 408-295-3433
  • Fax: 408-293-4872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: BART A CAREY
Title or Position: OWNER
Credential: MD
Phone: 408-295-3433