Healthcare Provider Details

I. General information

NPI: 1083141857
Provider Name (Legal Business Name): EYE CARE INSTITUTE, A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3035 CLEVELAND AVE STE 100
SANTA ROSA CA
95403-3037
US

IV. Provider business mailing address

3035 CLEVELAND AVE STE 100
SANTA ROSA CA
95403-3037
US

V. Phone/Fax

Practice location:
  • Phone: 707-546-9800
  • Fax:
Mailing address:
  • Phone: 707-545-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: ARWA P ALSAMARAE
Title or Position: PRESIDENT
Credential: MD
Phone: 707-525-6485