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General NPI Number Information
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NPI Number | 1972774651
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Entity Type | Organization
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Legal Business Name | CALIFORNIA EYE CLINIC
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Dates
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Enumeration Date | 03/20/2008
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 1200 CENTRAL BLVD STE A
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City | BRENTWOOD
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State | CA
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Zip | 94513-2227
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Country | US
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Telephone | 925-516-0888
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2539
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City | ANTIOCH
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State | CA
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Zip | 94531-2539
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Country | US
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Telephone | 925-754-2300
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CARLIE DIAZ
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Credential |
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Telephone | 925-754-2300
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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 | SD0128122
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License Number State | CA
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