NPIMap

Organization Active NPI

Eye Center of Northern California

  • Ambulatory Surgical Clinic/Center
  • El Cerrito, CA
National Provider Identifier
1083874648
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
140000382 Issued in CA
Legal business name
EYE CENTER OF NORTHERN CALIFORNIA
Practice address
6500 Fairmount Ave
El Cerrito, CA 94530-3667
Phone
(510) 525-2600
Fax
(510) 524-1887
NPI assigned
Jun 16, 2008
Organization subpart
Yes
Parent organization
EYE CENTER OF NORTHERN CALIFORNIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Dr. William Ellis, M.D.
Title
Director/Owner
Phone
(510) 525-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 140000382 CA Primary

Addresses

Primary practice location

6500 Fairmount Ave
El Cerrito, CA 94530-3667

Mailing address

6500 Fairmount Ave
El Cerrito, CA 94530-3667
Phone (510) 525-2600

Other identifiers 2

IdentifierTypeStateIssuer
G000197420MedicaidCA
ZZZ38409ZOtherCAPTAN#

Other names 1

  • Ellis Eye & Laser Medical Cnter Doing business as

National Provider Directory

National Provider Directory
Part of
William Ellis MD Inc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1083874648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 FAIRMOUNT AVE",
            "city": "EL CERRITO",
            "state": "CA",
            "postal_code": "945303667",
            "telephone_number": "510-525-2600",
            "fax_number": "510-524-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 FAIRMOUNT AVE",
            "city": "EL CERRITO",
            "state": "CA",
            "postal_code": "945303667",
            "telephone_number": "510-525-2600",
            "fax_number": "510-524-1887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CENTER OF NORTHERN CALIFORNIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYE CENTER OF NORTHERN CALIFORNIA",
        "enumeration_date": "2008-06-16",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "510-525-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "140000382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G000197420",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN#",
            "identifier": "ZZZ38409Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellis Eye & Laser Medical Cnter",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Cerrito, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.