Fifth Optometric Care of California
Organization Active NPI Optometrist · El Cerrito, CA
NPI 1548022510 · NPPES record last updated Jan 25, 2024
Key facts
- NPI
- 1548022510
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- FIFTH OPTOMETRIC CARE OF CALIFORNIA
- Practice address
- 11780 San Pablo Ave Ste B
El Cerrito, CA 94530-7103 - Phone
- (510) 234-1730
- NPI assigned
- Jan 25, 2024
- Organization subpart
- No
Authorized official
- Name
- Brittany Harrison
- Title
- Director
- Phone
- (510) 234-1730
Other NPIs on the same Medicare enrollment 10
Corporate family (same tax ID) 10
Practitioners 4
-
Kerry W H Feng, OD
-
Gerald John Garrels II, O.D.
-
Rahul Laxman Keswani, O.D.
-
Allen Luong, OD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230808001819 | CA | Part B Supplier - Clinic/Group Practice | 4284096298 |
Receives reassigned benefits from 62 practitioners 10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bakersfield, CA; Turlock, CA; Taft, CA; San Jose, CA; Rancho Cordova, CA; Lake Forest, CA; Elk Grove, CA; El Cerrito, CA… |
National Provider Directory
- Tax ID family
- Fifth Optometric Care O
Locations
214 Jackson St
San Jose, CA 95112
Phone (408) 293-3730
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
11780 San Pablo Ave Ste B
El Cerrito, CA 94530-7103
Mailing address
3333 Quality Dr
Rancho Cordova, CA 95670-7985
Other names
- WEST COUNTY OPTOMETRY
Other providers in El Cerrito, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.