Elite Eyecare Medical Group a Medical Corporation

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

ELITE EYECARE MEDICAL GROUP A MEDICAL CORPORATION

Doing business as

Santa Ynez Valley Optical

Practice address

2040 Viborg Rd Ste 240
Solvang, CA 93463

Phone

(805) 688-0707

Fax

(805) 693-9839

NPI assigned

Jul 19, 2018

Last updated

Jan 4, 2024By 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

Kenneht Kendall, OD

Title

Ceo

Phone

(805) 925-2637

Specialties & licenses 1

Addresses

Other names 1

• Santa Ynez Valley Optical Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1659857928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 E STOWELL RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547001",
            "telephone_number": "805-925-2637",
            "fax_number": "805-614-7718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 VIBORG RD STE 240",
            "city": "SOLVANG",
            "state": "CA",
            "postal_code": "93463",
            "telephone_number": "805-688-0707",
            "fax_number": "805-693-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE EYECARE MEDICAL GROUP A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-19",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "KENDALL",
        "authorized_official_first_name": "KENNEHT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "805-925-2637",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Santa Ynez Valley Optical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Santa Ynez Valley Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Janine Elise Doolan, LMFT, PMH-C.
• Dugan Therapy and Fitness Inc
• Janis B Dugan, P.T.
• Joseph J Dugan, P.T.
• Elite Eyecare Medical Group a Medical Corporation (Shepard Eye Center)
• Amanda Kohr Erben, OTR/L
• Cara Evans, MFTT
• Family Counseling and Trauma Healing Center, Inc.
• Family Eyecare Optometry Center PC
• Michael P Fangman, M.D.

• Eyewear Supplier in Solvang, CA
• Providers in Solvang, CA by specialty
• Eyewear Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.