Enterprise Optometry Group
Organization Active NPI Optometrist · Redding, CA
NPI 1811023724 · NPPES record last updated Sep 17, 2019
Key facts
- NPI
- 1811023724
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 6443T (CA)
- Legal business name
- ENTERPRISE OPTOMETRY GROUP
- Practice address
- 3080 Victor Ave
Redding, CA 96002-1449 - Phone
- (530) 222-3166
- Fax
- (530) 222-6539
- NPI assigned
- Feb 26, 2007
- Organization subpart
- No
Authorized official
- Name
- Amanda Callaway
- Title
- Insurance Supervisor
- Phone
- (530) 222-3166
Practitioners 4
-
Diana Isabel Iraheta, O.D
-
Theresa T Asato, O.D.
-
Stacy Catherine Cullum, O.D.
-
Richard Arthur Martin, O.D.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 6443T | CA | Yes |
Addresses
Primary practice location
3080 Victor Ave
Redding, CA 96002-1449
Mailing address
3080 Victor Ave
Redding, CA 96002-1449
Phone (530) 222-3166
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ71464Y | Other | CA | BLUE SHIELD OF CALIFORNIA |
| SD0064430 | Medicaid | CA |
Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.