Healthcare Provider Details

I. General information

NPI: 1679661714
Provider Name (Legal Business Name): TURLOCK EYECARE OPTOMETRIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 COLORADO AVE SUITE A
TURLOCK CA
95382-2002
US

IV. Provider business mailing address

2020 COLORADO AVE SUITE A
TURLOCK CA
95382-2002
US

V. Phone/Fax

Practice location:
  • Phone: 209-667-6211
  • Fax: 209-667-2574
Mailing address:
  • Phone: 209-667-6211
  • Fax: 209-667-2574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. COLLIN ROBILLARD
Title or Position: OWNER
Credential: O.D.
Phone: 209-667-6211