Charles Howard Bailey, O.D.

Individual provider Active NPI Corneal and Contact Management Optometrist · Berkeley, CA

NPI 1407993017 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1407993017
Entity type
Individual (NPI type 1)
Primary specialty
Corneal and Contact Management Optometrist 152WC0802X
License
07410TPG (CA)
Practice address
360 Minor Hall
Berkeley, CA 94720-2020
Phone
(510) 642-5365
Fax
(510) 642-8012
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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)
Yes

State licenses

LicenseStateTypeSpecialty
7410CAMDClinical Social Worker
07410TPGCAMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California at Berkeley Past
since Jun 7, 1991
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 07410TPG CA Yes

Addresses

Primary practice location

360 Minor Hall
Berkeley, CA 94720-2020

Mailing address

360 Minor Hall
Berkeley, CA 94720-2020
Phone (510) 642-5365

Other providers in Berkeley, CA

All providers in Berkeley, CA · Corneal and Contact Management Optometrist in California

Sources for this page

Verify at the official NPI Registry.