NPIMap

Organization Active NPI

For Eyes Vision Plan, Inc.

  • Optometrist
  • Berkeley, CA
National Provider Identifier
1396866497
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10272 Issued in CA
Legal business name
FOR EYES VISION PLAN, INC.
Practice address
2112 Shattuck Ave
Berkeley, CA 94704-1209
Phone
(510) 644-0909
Fax
(510) 540-5542
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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

Authorized official

Name
Philip Wolman
Title
Owner
Phone
(305) 557-9004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 10272 CA Primary

Addresses

Primary practice location

2112 Shattuck Ave
Berkeley, CA 94704-1209

Mailing address

2112 Shattuck Ave
Berkeley, CA 94704-1209
Phone (510) 644-0909

National Provider Directory

National Provider Directory

Locations

855 El Camino Real
Ste 84
Palo Alto, CA 94301
Phone (650) 323-4051

120 Kearny St
Ste 52
San Francisco, CA 94108
Phone (415) 781-2002

423 Washington St
San Francisco, CA 94111
Phone (415) 981-0909

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378166400000",
    "number": "1396866497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 SHATTUCK AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041209",
            "telephone_number": "510-644-0909",
            "fax_number": "510-540-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 SHATTUCK AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041209",
            "telephone_number": "510-644-0909",
            "fax_number": "510-540-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOR EYES VISION PLAN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2013-09-03",
        "status": "A",
        "authorized_official_last_name": "WOLMAN",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-557-9004"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; 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.