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Organization
STANISLAUS VISION ASSOCIATES OPTOMETRIC GROUP INC
Active
Organization
STANISLAUS VISION ASSOCIATES OPTOMETRIC GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SPENCER H WHATCOTT OD (PRESIDENT)
(209) 524-4626
Entity
Organization
Contact information
Practice address
1700 MCHENRY AVENUE, SUITE 77, MODESTO, CA 95350-4318
(209) 524-4626
(209) 524-1046
Mailing address
1700 MCHENRY AVENUE, SUITE 77, MODESTO, CA 95350-4318
(209) 524-4626
(209) 524-1046
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OR15
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02421
MEDICAL EYE SERVICES
—
05
—
GSD000120
—
CA
01
—
ST1529366
CLARITY VISION
—
Enumeration date
11/17/2006
Last updated
02/06/2012
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