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General NPI Number Information
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NPI Number | 1154759785
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Entity Type | Organization
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Legal Business Name | NORTHRIDGE EYE CARE, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 530 MAIN ST
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City | RED BLUFF
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State | CA
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Zip | 96080-3438
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Country | US
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Telephone | 530-529-1750
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Fax | 530-529-4551
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Provider Business Mailing Address
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Address Line | 530 MAIN ST
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City | RED BLUFF
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State | CA
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Zip | 96080-3438
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Country | US
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Telephone | 530-529-1750
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Fax | 530-529-4551
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Authorized Official
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Title or Position | OWNER
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Name | BRIAN OWEN HAUGEN
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Credential | MD
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Telephone | 530-529-1750
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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