Empire Eye Doctors Medical Group Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G32243 Issued in CA

Legal business name

EMPIRE EYE DOCTORS MEDICAL GROUP INC

Practice address

720 4TH St
Santa Rosa, CA 95404-4421

Phone

(707) 575-3800

Fax

(707) 528-4967

NPI assigned

Oct 21, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Penny Dow

Title

Billing Manager

Phone

(707) 575-3800

Specialties & licenses 6

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1003806068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 4TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044421",
            "telephone_number": "707-575-3800",
            "fax_number": "707-528-4967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 4TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044421",
            "telephone_number": "707-575-3800",
            "fax_number": "707-528-4967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPIRE EYE DOCTORS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-21",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "DOW",
        "authorized_official_first_name": "PENNY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "707-575-3800"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8739T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "T10471",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "8817T",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G32243",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G57122",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G32019",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CP5395",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0016130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shera Emis
• Jordan Sidney Emison
• Sara Emmanuel
• Emily Kathleen Emmerson, LMFT
• Debi M. Emmons
• Empire Traditional Chinese Medicine
• Veronica Encinas, MFTI
• Araceli Encizo-Gonzalez
• Alexander Scott Endicott, LVN
• Endoscopy Center of Santa Rosa

• Ophthalmology Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.