Petaluma Eye Care Optometric Associates, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

04916T Issued in CA

Legal business name

PETALUMA EYE CARE OPTOMETRIC ASSOCIATES, INC.

Practice address

1225 N McDowell Blvd
Petaluma, CA 94954-1112

Phone

(707) 763-2020

Fax

(707) 763-4735

NPI assigned

Oct 4, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Ronald L. Harris, O.D.

Title

Owner

Phone

(707) 763-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

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

• Michaela Melissa Chavez, O.D.

  • Optometrist
  • Santa Cruz, CA
  • NPI 1083055750
  NPD
• Tina Cheung, O.D.

  • Optometrist
  • San Francisco, CA
  • NPI 1306213160
  NPD

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

{
    "created_epoch": "1380844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449705600000",
    "number": "1578990552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949541112",
            "telephone_number": "707-763-2020",
            "fax_number": "707-763-4735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949541112",
            "telephone_number": "707-763-2020",
            "fax_number": "707-763-4735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETALUMA EYE CARE OPTOMETRIC ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-04",
        "last_updated": "2015-12-10",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-763-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "04916T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7789740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Personal Hearing Solutions, Inc.
• Petaluma Acupuncture Center
• Petaluma C.C. Inc. (Petaluma Care and Rehabilitation)
• Petaluma City Schools
• Petaluma Emergency Physicians Medical Corporation
• Petaluma Eye Care Optometric Associates, Inc. a Professional Corp.
• Petaluma Family Dental Care
• Petaluma Family Therapy Inc
• Petaluma Health Center Inc (Petaluma Health Center)
• Petaluma Health Center, Inc (Petaluma Eye Care)

• Optometrist in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; 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.