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General NPI Number Information
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NPI Number | 1841383882
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Entity Type | Organization
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Legal Business Name | VITREO-RETINAL MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 5775 GREENBACK LN
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City | SACRAMENTO
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State | CA
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Zip | 95841-2013
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Country | US
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Telephone | 916-339-3655
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Fax | 916-339-3658
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Provider Business Mailing Address
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Address Line | 3 PARK CENTER DR STE 100
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City | SACRAMENTO
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State | CA
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Zip | 95825-8340
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Country | US
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Telephone | 916-596-2027
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOEL PEARLMAN
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Credential | MD
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Telephone | 916-596-2027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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