MEDICARE: SUNSHINE EYE SERVICES

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	174400000X	Specialist	C28965	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

General Provider Information

NPI Number	:	1427155969
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE EYE SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 7422
Second Line	:
City	:	OXNARD
State	:	CA
Zip	:	93031-7422
Country	:	US
Telephone Number	:	805-483-4804
Fax Number	:	805-483-1304

Provider Business Practice Location Address
First Line	:	200 SOUTH A STREET
Second Line	:	SUITE 210
City	:	OXNARD
State	:	CA
Zip	:	93030-5717
Country	:	US
Telephone Number	:	805-483-4804
Fax Number	:	805-483-1304

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MISS JOHN ALSTON HOUSEHOLDER
Credential	:	M.D.
Telephone Number	:	805-483-4804

Provider Enumeration Date	:	09/19/2006
Last Update Date	:	11/09/2007

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Directions to “SUNSHINE EYE SERVICES ” Practice Location

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