# PACIFIC CHILDRENS EYECARE MEDICAL GROUP

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

## Provider details

- **NPI number:** 1467558361
- **Authorized official:** THEODORE OTIS PAUL M.D. (OWENER)
- **Authorized official phone:** (925) 363-8170

## Contact information

- **Practice address:** 1517 NORTH POINT ST., \#471, SAN FRANCISCO, CA 94123
- **Practice address phone:** (415) 923-3926
- **Practice address fax:** (415) 276-3783
- **Mailing address:** 5528 PACHECO BLVD, BUILDING A, PACHECO, CA 94553-5126
- **Mailing address phone:** (925) 363-8170
- **Mailing address fax:** (925) 363-4995

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | A22914 | CA | Yes |

## Other

- **Enumeration date:** 09/16/2006
- **Last updated:** 07/11/2007