Provider Demographics
NPI:1548544091
Name:VISIONCARE OF CALIFORNIA
Entity type:Organization
Organization Name:VISIONCARE OF CALIFORNIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHASHATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-454-4647
Mailing Address - Street 1:1049 COCHRANE RD
Mailing Address - Street 2:STE 130
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-9077
Mailing Address - Country:US
Mailing Address - Phone:408-778-4633
Mailing Address - Fax:408-778-1048
Practice Address - Street 1:1049 COCHRANE RD
Practice Address - Street 2:STE 130
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-9077
Practice Address - Country:US
Practice Address - Phone:408-778-4633
Practice Address - Fax:408-778-1048
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMERGING VISION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty