Fred WM Stellhorn Optometric Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

5215 TPL Issued in CA

Legal business name

FRED WM STELLHORN OPTOMETRIC CORPORATION

Doing business as

Manteca Optometric Eye Care Center

Practice address

140 N Fremont St Ste a
Manteca, CA 95336-4729

Phone

(209) 823-3151

Fax

(209) 823-9712

NPI assigned

Mar 24, 2008

Last updated

Aug 25, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Frederick William Stellhorn, O.D.

Title

Optometrist

Phone

(209) 823-3151

Specialties & licenses 7

Addresses

Other identifiers 1

Other names 1

• Manteca Optometric Eye Care Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Meeral R Bhakta, O.D.

  • Optometrist
  • Hayward, CA
  • NPI 1972939411
  Medicare reassignment NPD
• Rajpreet Kaur, OD

  • Optometrist
  • Fresno, CA
  • NPI 1427432681
  Medicare reassignment NPD
• Prudence Ann Smith, O.D.

  • Optometrist
  • Livermore, CA
  • NPI 1790129633
  Medicare reassignment NPD
• Quyen The Truong, OD

  • Optometrist
  • Elk Grove, CA
  • NPI 1205305547
  Medicare reassignment NPD
• Keith Yun Kong Wong, O.D.

  • Optometrist
  • Modesto, CA
  • NPI 1336201615
  Medicare reassignment NPD
• Jennifer Yen Luu, O.D., M.S.

  • Optometrist
  • Discovery Bay, CA
  • NPI 1669814430
  NPD
• Ronald F Janda, OD

  • Optometrist
  • Modesto, CA
  • NPI 1003843087
  NPD (past)
• Derron Timothy Lee, O.D.

  • Optometrist
  • Stockton, CA
  • NPI 1144313552
  NPD (past)
• Jeffrey Stewart Ricks, O.D.

  • Optometrist
  • Fremont, CA
  • NPI 1043403595
  NPD (past)

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472083200000",
    "number": "1124290721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 N FREMONT ST STE A",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364729",
            "telephone_number": "209-823-3151",
            "fax_number": "209-823-9712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 N FREMONT ST STE A",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364729",
            "telephone_number": "209-823-3151",
            "fax_number": "209-823-9712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED WM STELLHORN OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2016-08-25",
        "status": "A",
        "authorized_official_last_name": "STELLHORN",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "209-823-3151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5215 TPL",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CA",
            "license": "5215 TPL",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CA",
            "license": "5215 TPL",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "5215 TPL",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "CA",
            "license": "5215 TPL",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "5215 TPL",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "CA",
            "license": "5215 TPL",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0052150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manteca Optometric Eye Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Foad Elahi MD California Center of Pain Medicine and Rehabilitation I
• Amanda Nicole Cervantes Fontes, OTR/L
• Cindy Ford, MFT
• Ariana Fraga
• Elizabeth Marie Frank, LMFT
• Brittney Frederick
• Angela French, MS
• Christine Ann Frey, PHARMD
• Anita Freyman-Danielsen, M.S., LMFT
• Jackie Friedrikson, CMT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.