Stanislaus Optometric Center, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT8000T Issued in CA

Legal business name

STANISLAUS OPTOMETRIC CENTER, INC.

Practice address

4028 Dale Rd Ste 102
Modesto, CA 95356-9505

Phone

(209) 527-2020

Fax

(209) 527-5079

NPI assigned

May 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Edward F. Nuccio, O.D,

Title

Owner

Phone

(209) 527-2020

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114131141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4028 DALE RD STE 102",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569505",
            "telephone_number": "209-527-2020",
            "fax_number": "209-527-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4028 DALE RD STE 102",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569505",
            "telephone_number": "209-527-2020",
            "fax_number": "209-527-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANISLAUS OPTOMETRIC CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NUCCIO",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-527-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D,"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT8000T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanislaus County Office of Education
• Stanislaus County Office of Education
• Stanislaus County, Dept of Aging and Veterans Services, MSSP
• Stanislaus Family Medicine Residency
• Stanislaus Health and Wellness Inc
• Stanislaus Orthopaedic and Sports Medicine Clinic
• Stanislaus Orthopaedics Sports Medicine Clinic
• Stanislaus Subacute Rehab LLC
• Stanislaus Surgical Hospital LLC
• Stanislaus Union School District

• Optometrist in Modesto, CA
• Providers in Modesto, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.