NPIMap

Organization Active NPI

Elite Eyecare Medical Group a Medical Corporation

Doing business as Shepard Eye Center

  • Ophthalmology Physician
  • San Luis Obispo, CA
National Provider Identifier
1417776253
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
ELITE EYECARE MEDICAL GROUP A MEDICAL CORPORATION
Doing business as
Shepard Eye Center
Practice address
689 Tank Farm Rd Ste 100
San Luis Obispo, CA 93401-7078
Phone
(805) 781-3937
NPI assigned
Oct 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Authorized official

Name
Shahriar Rami Zarnegar, MD
Title
Medical Doctor
Phone
(805) 925-2637

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

689 Tank Farm Rd Ste 100
San Luis Obispo, CA 93401-7078

Mailing address

910 E Stowell Rd
Santa Maria, CA 93454-7001
Phone (805) 925-2637

Other practice location 1

234 Heather Ct Ste 102
Templeton, CA 93465-8765
Phone (805) 434-5970

Other names 1

  • Shepard Eye Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Elite Eyecare Medical Group a Medical Corporation10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

910 E Stowell Rd
Santa Maria, CA 93454
Phone (805) 925-2637

234 Heather Ct
Ste 102
Templeton, CA 93465
Phone (805) 434-5970

NPI Registry JSON

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728345600000",
    "number": "1417776253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 E STOWELL RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547001",
            "telephone_number": "805-925-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "689 TANK FARM RD STE 100",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017078",
            "telephone_number": "805-781-3937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "234 Heather Ct Ste 102",
            "address_purpose": "LOCATION",
            "city": "Templeton",
            "state": "CA",
            "postal_code": "934658765",
            "country_code": "US",
            "telephone_number": "805-434-5970",
            "fax_number": "805-737-5973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELITE EYECARE MEDICAL GROUP A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A",
        "authorized_official_last_name": "ZARNEGAR",
        "authorized_official_first_name": "SHAHRIAR",
        "authorized_official_middle_name": "RAMI",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "805-925-2637",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shepard Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.