Organization
SYLVAN EYE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERRY ALAN HORNER (VICE-PRESIDENT)
(209) 758-5531
Entity
Organization
Contact information
Practice address
1011 SYLVAN AVE, MODESTO, CA 95350-1692
(209) 575-2020
Mailing address
1011 SYLVAN AVE, MODESTO, CA 95350-1692
(209) 575-2020
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3929510001
DMERC
CA
05
—
GR0088410
—
CA
01
—
ZZZ00823Z
BLUE SHIELD
CA
Enumeration date
01/09/2008
Last updated
01/09/2008
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