Organization Active NPI

Amedco California Inc

  • Optometrist
  • Santa Rosa, CA
National Provider Identifier
1497027544
Registry record updated Feb 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
AMEDCO CALIFORNIA INC
Practice address
1054 Santa Rosa PLZ
Santa Rosa, CA 95401-6345
Phone
(707) 544-3000
Fax
(707) 544-7348
NPI assigned
Feb 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2012

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

Authorized official

Name
Dr. Galen Grayson, M.D.
Title
Medical Director
Phone
(704) 295-0001

Specialties & licenses 1

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

Addresses

Primary practice location

1054 Santa Rosa PLZ
Santa Rosa, CA 95401-6345

Mailing address

1054 Santa Rosa PLZ
Santa Rosa, CA 95401-6345
Phone (707) 544-3000

Other names 1

  • Optical World Inc Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Amedco California Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1328486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328486400000",
    "number": "1497027544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1054 SANTA ROSA PLZ",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954016345",
            "telephone_number": "707-544-3000",
            "fax_number": "707-544-7348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1054 SANTA ROSA PLZ",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954016345",
            "telephone_number": "707-544-3000",
            "fax_number": "707-544-7348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMEDCO CALIFORNIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-06",
        "last_updated": "2012-02-06",
        "status": "A",
        "authorized_official_last_name": "GRAYSON",
        "authorized_official_first_name": "GALEN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "704-295-0001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optical World Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; 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.