MEDICARE: EYECARE FOR VISION OPTOMETRY, INC

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1548067655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYECARE FOR VISION OPTOMETRY, INC

Provider Business Mailing Address
First Line	:	6755 MIRA MESA BLVD STE 123-173
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-4392
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16516 BERNARDO CENTER DR STE 300
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-2552
Country	:	US
Telephone Number	:	619-302-0371
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. PATTY L CHENG
Credential	:	OD
Telephone Number	:	619-665-3769

Provider Enumeration Date	:	02/26/2025
Last Update Date	:	06/09/2025

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