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General NPI Number Information
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NPI Number | 1871650689
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Entity Type | Organization
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Legal Business Name | GRASS VALLEY EYE CARE OPTOMETRIC, INC.
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 11/15/2023
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Provider Practice Location Address
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Address Line | 998 PLAZA DR
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City | GRASS VALLEY
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State | CA
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Zip | 95945-9532
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Country | US
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Telephone | 530-273-6000
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Fax | 530-272-8459
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Provider Business Mailing Address
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Address Line | 998 PLAZA DR
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City | GRASS VALLEY
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State | CA
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Zip | 95945-9532
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Country | US
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Telephone | 530-273-6000
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Fax | 530-272-8459
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TANYA D. MARKIS-MEYER
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Credential | OD
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Telephone | 530-273-6000
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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 | 10668TPG
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License Number State | CA
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