Organization
EYE CENTER OF NORTHERN CALIFORNIA
Active
Parent organization
EYE CENTER OF NORTHERN CALIFORNIA
Other names
Ellis Eye & Laser Medical Cnter
Organization subpart
Yes
Provider details
NPI number
Legal business name
EYE CENTER OF NORTHERN CALIFORNIA
Authorized official
DR. WILLIAM ELLIS M.D. (DIRECTOR/OWNER)
(510) 525-2600
Entity
Organization
Contact information
Practice address
6500 FAIRMOUNT AVE, EL CERRITO, CA 94530-3667
(510) 525-2600
(510) 524-1887
Mailing address
6500 FAIRMOUNT AVE, EL CERRITO, CA 94530-3667
(510) 525-2600
(510) 524-1887
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
140000382
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G000197420
—
CA
01
—
ZZZ38409Z
PTAN#
CA
Enumeration date
06/16/2008
Last updated
06/16/2008
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