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Organization
FOGG REMINGTON EYECARE, INC.
Active
Organization
FOGG REMINGTON EYECARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAULA PENDLEY (FINANCIAL SUPERVISOR)
(559) 226-3975
Entity
Organization
Contact information
Practice address
1817 SHAW AVE, SUITE 104, CLOVIS, CA 93611-4069
(559) 449-5010
(559) 449-5014
Mailing address
1360 E HERNDON AVE, SUITE 401, FRESNO, CA 93720-3326
(559) 449-5010
(559) 449-5014
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1304310004
CIGNA MEDICARE DMERC
CA
05
—
GR0078921
—
CA
05
—
GSD004052
—
CA
Enumeration date
04/08/2006
Last updated
04/05/2022
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