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Organization
PACIFIC VISION MEDICAL CENTER
Active
Organization
PACIFIC VISION MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY A ENINGER M.D. (PARTNER)
(707) 465-2020
Entity
Organization
Contact information
Practice address
515 E WASHINGTON BLVD, CRESCENT CITY, CA 95531-8342
(707) 465-2020
(707) 465-6252
Mailing address
515 E WASHINGTON BLVD, CRESCENT CITY, CA 95531-8342
(707) 465-2020
(707) 465-6252
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
ZZZ28910Z
CA
207W00000X
Ophthalmology Physician
Primary
ZZZ28910Z
CA
332H00000X
Eyewear Supplier
0534820001
CA
Other
Enumeration date
01/09/2007
Last updated
06/29/2020
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