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Organization
VISION CARE CENTER OF SOUTHEASTERN CA AN OPTOMETRIC CORP.
Active
Organization
VISION CARE CENTER OF SOUTHEASTERN CA AN OPTOMETRIC CORP.
Active
Other names
VISION CARE CENTER OF SOUTHEASTERN CA An Optometric Corp.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD LEE BARNISKE O.D. (OPTOMETRIST)
(760) 351-2020
Entity
Organization
Contact information
Practice address
260 MAIN ST, BRAWLEY, CA 92227-2351
(760) 351-2020
(760) 344-4552
Mailing address
PO BOX 1071, BRAWLEY, CA 92227-1071
(760) 351-2020
(760) 344-4552
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
005636
CA
152WC0802X
Corneal and Contact Management Optometrist
005636
CA
152WL0500X
Low Vision Rehabilitation Optometrist
005636
CA
152WP0200X
Pediatric Optometrist
005636
CA
152WV0400X
Vision Therapy Optometrist
005636
CA
152WX0102X
Occupational Vision Optometrist
005636
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548465222
—
CA
01
—
1982760310
NPI
CA
01
—
WY2550
MEDICARE PROVIDER
CA
Enumeration date
06/20/2007
Last updated
02/11/2015
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