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General NPI Number Information
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NPI Number | 1073658795
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Entity Type | Organization
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Legal Business Name | EYE AND VISION CARE OPTOMETRIC GROUP
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 5300 HOLLISTER AVE
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City | SANTA BARBARA
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State | CA
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Zip | 93111-2306
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Country | US
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Telephone | 805-692-6977
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Fax | 805-692-6987
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Provider Business Mailing Address
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Address Line | 5300 HOLLISTER AVE
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City | SANTA BARBARA
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State | CA
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Zip | 93111-2306
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Country | US
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Telephone | 805-692-6977
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Fax | 805-692-6987
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Authorized Official
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Title or Position | PARTNER
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Name | DR. LUKE WERKHOVEN
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Credential | O.D.
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Telephone | 805-692-6977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 11977T
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License Number State | CA
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