Eye Medical Clinic of Fresno, Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

EYE MEDICAL CLINIC OF FRESNO, INC

Practice address

1360 E Herndon Ave
Suite 301
Fresno, CA 93720-3326

Phone

(559) 486-5000

Fax

(559) 439-7854

NPI assigned

Aug 2, 2006

Last updated

Nov 24, 2009By 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. George A. Bertolucci, M.D.NPI 1447267505

Title

President

Phone

(559) 449-5097

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Eye Medical Clinic of Fresno, Inc.

  • Ophthalmology Physician
  • Fresno, CA
  • NPI 1659388700

  O20050504001241

  Same enrollment

Locations

Practitioners 30

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.

• George Angelo Bertolucci

  • Ophthalmology Physician
  • Fresno, CA
  • NPI 1447267505
  NPD (past) Authorized official
• Maziar Bidar, MD

  • Ophthalmology Physician
  • Fresno, CA
  • NPI 1689693657
  NPD
• Harinderpal Singh Chahal, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Bakersfield, CA
  • NPI 1942580253

  Ophthalmology

  NPD
• Allyson Denise Chun, O.D.

  • Optometrist
  • Fresno, CA
  • NPI 1881000404
  NPD
• Jack Douglas Clark, M.D.

  • Ophthalmology Physician
  • Fresno, CA
  • NPI 1265571608
  NPD
• Atif Collins, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Fresno, CA
  • NPI 1891010948

  Single Specialty

  NPD
• Steven G. Fogg, M.D.

  • Ophthalmology Physician
  • Fresno, CA
  • NPI 1982666871
  NPD
• Katherine Ha, OD

  • Optometrist
  • Pomona, CA
  • NPI 1942727243
  NPD
• Maurice Jackson, OD

  • Optometrist
  • Fresno, CA
  • NPI 1184390296
  NPD
• John Joseph Kinney, OD

  • Optometrist
  • Fresno, CA
  • NPI 1407872344
  NPD
• Neesurg Sunil Mehta

  • Retina Specialist (Ophthalmology) Physician
  • Sacramento, CA
  • NPI 1740643097
  NPD
• Susan Diane Mencarini, OD

  • Optometrist
  • Clovis, CA
  • NPI 1871519710
  NPD

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259020800000",
    "number": "1306853452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 E HERNDON AVE",
            "address_2": "SUITE 301",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203326",
            "telephone_number": "559-486-5000",
            "fax_number": "559-439-7854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 E HERNDON AVE",
            "address_2": "SUITE 301",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203326",
            "telephone_number": "559-486-5000",
            "fax_number": "559-439-7854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE MEDICAL CLINIC OF FRESNO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2009-11-24",
        "status": "A",
        "authorized_official_last_name": "BERTOLUCCI",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-449-5097",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ17909Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD005250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Tammy Ann Exum, LMFT
• Eye and Vision Central California Inc
• Eye Medical Clinic of Fresno, in.C (Eye Medical Center of Fresno)
• Eye Medical Clinic of Fresno, Inc.
• Eye Medical Clinic of Fresno, Inc. (Eye Medical Center of Fresno)
• Eyemart Express LLC
• Eyemart Express LTD
• Joyce Yayoi Ezaki-Yamaguchi, R.D.

• Ophthalmology Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; 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.