Organization
EYE CENTER OPTOMETRICS, A PROFESSIONAL CORPORATION
Active
Other names
Eye Center Optometrics, A Professional Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
LORI L COOPER (COMMUNICATIONS DIRECTOR)
(916) 726-1818
Entity
Organization
Contact information
Practice address
5959 GREENBACK LN, SUITE 130, CITRUS HEIGHTS, CA 95621-4700
(916) 726-1818
(916) 726-1822
Mailing address
5959 GREENBACK LN, SUITE 130, CITRUS HEIGHTS, CA 95621-4700
(916) 726-1818
(916) 726-1822
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
COR 1075
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GSD001120
—
CA
05
—
GSD001121
—
CA
05
—
GSD001122
—
CA
01
—
ZZZ50557Z
BLUE SHIELD PIN
CA
01
—
ZZZ50558Z
BLUE SHIELD PIN
CA
01
—
ZZZ69113Z
BLUE SHIELD PIN
CA
Enumeration date
03/05/2007
Last updated
03/31/2014
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