MEDICARE: DR. JEFFREY VERNE ALLGEIER 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	OPT 7115 TPA	CA
2	156FC0801X	Contact Lens Fitter	OPT 7115 TPA	CA
3	152WS0006X	Sports Vision Optometrist	OPT 7115 TPA	CA
4	152WP0200X	Pediatric Optometrist	OPT 7115 TPA	CA
5	152WX0102X	Occupational Vision Optometrist	OPT 7115 TPA	CA

General Provider Information

NPI Number	:	1821177858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY VERNE ALLGEIER O.D.

Provider Business Mailing Address
First Line	:	3133 PROFESSIONAL DR STE 14
Second Line	:
City	:	AUBURN
State	:	CA
Zip	:	95603-2463
Country	:	US
Telephone Number	:	530-888-0670
Fax Number	:	530-888-8652

Provider Business Practice Location Address
First Line	:	3133 PROFESSIONAL DR STE 14
Second Line	:
City	:	AUBURN
State	:	CA
Zip	:	95603-2463
Country	:	US
Telephone Number	:	530-888-0670
Fax Number	:	530-888-8652

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

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	01/03/2008

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