# PACIFIC VISION MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346399433
- **Authorized official:** LARRY A ENINGER M.D. (PARTNER)
- **Authorized official phone:** (707) 465-2020

## Contact information

- **Practice address:** 515 E WASHINGTON BLVD, CRESCENT CITY, CA 95531-8342
- **Practice address phone:** (707) 465-2020
- **Practice address fax:** (707) 465-6252
- **Mailing address:** 515 E WASHINGTON BLVD, CRESCENT CITY, CA 95531-8342
- **Mailing address phone:** (707) 465-2020
- **Mailing address fax:** (707) 465-6252

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | ZZZ28910Z | CA | — |
| 207W00000X | Ophthalmology Physician | ZZZ28910Z | CA | Yes |
| 332H00000X | Eyewear Supplier | 0534820001 | CA | — |

## Other

- **Enumeration date:** 01/09/2007
- **Last updated:** 06/29/2020