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General NPI Number Information
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NPI Number | 1538245162
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Entity Type | Organization
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Legal Business Name | GRANITE POINTE EYE CARE, INC.
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 9221 SIERRA COLLEGE BLVD SUITE 130
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City | ROSEVILLE
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State | CA
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Zip | 95661-5919
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Country | US
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Telephone | 916-797-6747
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Fax | 916-797-6728
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Provider Business Mailing Address
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Address Line | 9221 SIERRA COLLEGE BLVD SUITE 130
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City | ROSEVILLE
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State | CA
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Zip | 95661-5919
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Country | US
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Telephone | 916-797-6747
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Fax | 916-797-6728
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Authorized Official
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Title or Position | MANAGER
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Name | TAMI BLISS
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Credential |
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Telephone | 916-838-5532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 9831
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | 9831
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 152WS0006X
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Taxonomy Name | Sports Vision Optometrist
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License Number | 9831
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9831
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License Number State | CA
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