20 -20 Vision Associates Optometry
Organization Active NPI Optometrist · Riverside, CA
NPI 1124222997 · NPPES record last updated Jun 4, 2009
Key facts
- NPI
- 1124222997
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 5187T (CA)
- Legal business name
- 20 -20 VISION ASSOCIATES OPTOMETRY
- Practice address
- 6377 Riverside Ave
Suite 190
Riverside, CA 92506-3124 - Phone
- (951) 684-7822
- Fax
- (951) 684-0733
- NPI assigned
- Jun 13, 2007
- Organization subpart
- No
Authorized official
- Name
- Ms. Cheryl M. Everitt, O.D.
- Title
- Practice Owner, Partner
- Phone
- (951) 684-7822
Practitioners 3
-
Cheryl Marie Everitt, O.D.
-
Jason Timbol Flores, O.D.
-
Eugene Chongkon Kim, O.D.
National Provider Directory
Locations
6377 Riverside Ave
Ste 190
Riverside, CA 92506
Phone (909) 684-7822
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 10316T | CA | |
| Optometrist |
152W00000X | 5187T | CA | Yes |
| Optometrist |
152W00000X | 13309T | CA |
Addresses
Primary practice location
6377 Riverside Ave
Suite 190
Riverside, CA 92506-3124
Mailing address
6377 Riverside Ave
Suite 190
Riverside, CA 92506-3124
Phone (951) 684-7822
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0103160 | Medicaid | CA | |
| SD0051870 | Medicaid | CA | |
| DB2495 | Other | CA | RR MEDICARE |
Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.