# EYEXAM OF CA

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

## Provider details

- **NPI number:** 1457756363
- **Authorized official:** TAYLOR TEDDER (REGIONAL DIRECTOR OF EYEXAM OF CA)
- **Authorized official phone:** (805) 217-2974

## Contact information

- **Practice address:** 1101 GLENDALE GALLERIA, GLENDALE, CA 91210-1301
- **Practice address phone:** (818) 552-4440
- **Mailing address:** 11751 RANCHITO ST, EL MONTE, CA 91732-1317

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 15134 | CA | Yes |
| 305R00000X | Preferred Provider Organization | 15134 | CA | — |

## Other

- **Enumeration date:** 11/04/2014
- **Last updated:** 11/04/2014