Thomas Ward Burk, O.D.

Individual provider Active NPI Optometrist · Yuba City, CA

NPI 1295895985 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1295895985
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
OPT 4970 TPA (CA)
Practice address
1050 Live Oak Blvd
Yuba City, CA 95991-3415
Phone
(530) 671-1740
Fax
(530) 671-1380
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OPT 4970 TPACAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Eyecare, an Optometric Corporation Optometrist Past
since Jan 31, 2009
Accepting new patients
Advanced Eyecare, an Optometric Corporation Optometrist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT 4970 TPA CA Yes

Addresses

Primary practice location

1050 Live Oak Blvd
Yuba City, CA 95991-3415

Mailing address

PO Box 999
Yuba City, CA 95992-0999
Phone (530) 671-1740

Other identifiers

IdentifierTypeStateIssuer
SD0049700MedicaidCA

Other providers in Yuba City, CA

All providers in Yuba City, CA · Optometrist in California

Sources for this page

Verify at the official NPI Registry.