NPIMap

Organization Active NPI

Eye Care Institute, a Medical Corporation

  • Durable Medical Equipment & Medical Supplies
  • Rohnert Park, CA
National Provider Identifier
1609932342
Registry record updated May 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0399240001 Issued in CA
Legal business name
EYE CARE INSTITUTE, A MEDICAL CORPORATION
Practice address
1370 Medical Center Dr
Suite a
Rohnert Park, CA 94928-2934
Phone
(707) 585-6110
Fax
(707) 585-6145
NPI assigned
Dec 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2017

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

Authorized official

Name
Daniel G. Rich, M.D.
Title
Corporation President
Phone
(707) 546-9800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0399240001 CA Primary

Addresses

Primary practice location

1370 Medical Center Dr
Suite a
Rohnert Park, CA 94928-2934

Mailing address

1017 2ND St
Santa Rosa, CA 95404-6608
Phone (707) 546-9800

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ76363ZMedicaidCA

Other names 1

  • Santa Rosa Eye Physicians and Surgeons Medical Group, A Prof Corp Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Harris Barth and Anders4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495670400000",
    "number": "1609932342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 2ND ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954046608",
            "telephone_number": "707-546-9800",
            "fax_number": "707-546-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 MEDICAL CENTER DR",
            "address_2": "SUITE A",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282934",
            "telephone_number": "707-585-6110",
            "fax_number": "707-585-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE INSTITUTE, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2017-05-25",
        "status": "A",
        "authorized_official_last_name": "RICH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CORPORATION PRESIDENT",
        "authorized_official_telephone_number": "707-546-9800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "0399240001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ76363Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Santa Rosa Eye Physicians and Surgeons Medical Group, A Prof Corp",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Rohnert Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2017; 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.