Organization
FRED WM STELLHORN OPTOMETRIC CORPORATION
Active
Other names
Manteca Optometric Eye Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERICK WILLIAM STELLHORN O.D. (OPTOMETRIST)
(209) 823-3151
Entity
Organization
Contact information
Practice address
140 N FREMONT ST STE A, MANTECA, CA 95336-4729
(209) 823-3151
(209) 823-9712
Mailing address
140 N FREMONT ST STE A, MANTECA, CA 95336-4729
(209) 823-3151
(209) 823-9712
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5215 TPL
CA
152WC0802X
Corneal and Contact Management Optometrist
5215 TPL
CA
152WL0500X
Low Vision Rehabilitation Optometrist
5215 TPL
CA
152WP0200X
Pediatric Optometrist
5215 TPL
CA
152WS0006X
Sports Vision Optometrist
5215 TPL
CA
152WV0400X
Vision Therapy Optometrist
5215 TPL
CA
152WX0102X
Occupational Vision Optometrist
5215 TPL
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0052150
—
CA
Enumeration date
03/24/2008
Last updated
08/25/2016
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