1144401241 NPI number — CLEARVIEW EYECARE OPTOMETRY A PROFESSIONAL CORPORATION

Table of content: (NPI 1144401241)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144401241 NPI number — CLEARVIEW EYECARE OPTOMETRY A PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLEARVIEW EYECARE OPTOMETRY A PROFESSIONAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144401241
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/25/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
42220 10TH ST W STE 105
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LANCASTER
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93534-7075
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-945-9883
Provider Business Mailing Address Fax Number:
661-726-2898

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
42220 10TH ST W STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93534-7075
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-945-9883
Provider Business Practice Location Address Fax Number:
661-726-2898
Provider Enumeration Date:
11/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SILVERMAN
Authorized Official First Name:
CLIFFORD
Authorized Official Middle Name:
Authorized Official Title or Position:
OPTOMETRIST/PRESIDENT
Authorized Official Telephone Number:
661-945-9883

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  8588T , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: GSD005290 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com