Eye Associates of Sebastopol Medical Group

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

EYE ASSOCIATES OF SEBASTOPOL MEDICAL GROUP

Practice address

6574 Oakmont Dr Ste a
Santa Rosa, CA 95409-5958

Phone

(707) 579-2020

Fax

(707) 539-6183

NPI assigned

Feb 20, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Cathy A Udell

Title

Credentialling

Phone

(707) 823-7628

Specialties & licenses 1

Addresses

Tax ID family

Eye Associates of Sebastopol Medical Group 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.

• Eye Associates of Sebastopol Medical Group

  • Eyewear Supplier
  • Sebastopol, CA
  • NPI 1619012119
  NPD tax ID
• Eye Associates of Sebastopol Medical Group

  • Eyewear Supplier
  • Clearlake, CA
  • NPI 1770734659
  NPD tax ID

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598800419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6574 OAKMONT DR STE A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954095958",
            "telephone_number": "707-579-2020",
            "fax_number": "707-539-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6574 OAKMONT DR STE A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954095958",
            "telephone_number": "707-579-2020",
            "fax_number": "707-539-6183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE ASSOCIATES OF SEBASTOPOL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "UDELL",
        "authorized_official_first_name": "CATHY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALLING",
        "authorized_official_telephone_number": "707-823-7628",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen Evind, ASW
• Evolve Restorative Center
• Joanne Ewart, M.S.
• Diana Ewing, LVN
• Eberle A. Ewing, MD
• Eye Care Institute, a Medical Corporation
• Eye Care Institute, a Medical Corporation
• Eye Care Institute, a Medical Corporation
• Eye Care Institute, a Medical Corporation
• Gary J Eyre, DC

• Eyewear Supplier in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Eyewear Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.