Fifth Optometric Care of California

Organization Active NPI Optometrist · Taft, CA

NPI 1699504746 · NPPES record last updated Jul 29, 2024

Key facts

NPI
1699504746
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
Legal business name
FIFTH OPTOMETRIC CARE OF CALIFORNIA
Practice address
417 Center St
Taft, CA 93268-3510
Phone
(661) 765-4270
Fax
(661) 765-4279
NPI assigned
Jul 29, 2024
Organization subpart
No

Authorized official

Name
Brittany Harrison
Title
Director
Phone
(512) 316-4603

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 10

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

Practitioners 55

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

View all 55

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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 (11 organizations share this tax ID)

Locations

11780 San Pablo Ave
Ste B
El Cerrito, CA 94530
Phone (510) 234-1730

22681 Lake Forest Dr
Ste A2
Lake Forest, CA 92630
Phone (949) 837-2121

1001 Sylvan Ave
Ste B
Modesto, CA 95350
Phone (209) 575-2020

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X Yes

Addresses

Primary practice location

417 Center St
Taft, CA 93268-3510

Mailing address

3333 Quality Dr
Rancho Cordova, CA 95670-7985
Phone (661) 765-4270

Other names

  • Taft Eye Care Optometric Center Doing business as

Other providers in Taft, CA

All providers in Taft, CA · Optometrist in California

Sources for this page

Verify at the official NPI Registry.