MEDICARE: DR. SAUL MENDELSOHN O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	4968T	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4968T	OTHER	CA	CALIFORNIA OD LICENSE

General Provider Information

NPI Number	:	1376563908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAUL MENDELSOHN O.D.

Provider Business Mailing Address
First Line	:	5478 N PALM AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93704-1940
Country	:	US
Telephone Number	:	559-447-4990
Fax Number	:	559-447-4994

Provider Business Practice Location Address
First Line	:	5478 N PALM AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93704-1940
Country	:	US
Telephone Number	:	559-447-4990
Fax Number	:	559-447-4994

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	02/15/2026

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