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General NPI Number Information
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NPI Number | 1578814430
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Entity Type | Organization
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Legal Business Name | RIVERCITY DOCTORS OF OPTOMETRY INC.
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Dates
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Enumeration Date | 10/01/2012
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Last Update Date | 12/14/2012
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Provider Practice Location Address
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Address Line | 1315 ALHAMBRA BLVD STE 310
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City | SACRAMENTO
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State | CA
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Zip | 95816-5247
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Country | US
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Telephone | 916-452-2020
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Fax | 916-452-3365
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Provider Business Mailing Address
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Address Line | 1315 ALHAMBRA BLVD STE 310
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City | SACRAMENTO
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State | CA
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Zip | 95816-5247
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Country | US
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Telephone | 916-452-2020
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Fax | 916-452-3365
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRADY P. REMBLESKI
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Credential | O.D.
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Telephone | 916-452-2020
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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 | 5898T
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5510
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 11947T
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License Number State | CA
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