Apple Valley Family Optometry Centre

Primary specialty

OptometristTaxonomy code 152W00000X

License

7082T Issued in CA

Legal business name

APPLE VALLEY FAMILY OPTOMETRY CENTRE

Practice address

15972 Tuscola Rd
Suite 101
Apple Valley, CA 92307-2106

Phone

(760) 946-2700

Fax

(760) 946-3355

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Steven Bruce Wallis, O.D.

Title

Doctor

Phone

(760) 946-2700

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249516800000",
    "number": "1891826210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15972 TUSCOLA RD",
            "address_2": "SUITE 101",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072106",
            "telephone_number": "760-946-2700",
            "fax_number": "760-946-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15972 TUSCOLA RD",
            "address_2": "SUITE 101",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072106",
            "telephone_number": "760-946-2700",
            "fax_number": "760-946-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLE VALLEY FAMILY OPTOMETRY CENTRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2009-08-06",
        "status": "A",
        "authorized_official_last_name": "WALLIS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "760-946-2700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7082T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0070820",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ZZZ05917Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ58328Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Another Hurrican Project Inc.
• Euphemia Chinelo Anyaeche
• Apple Valley Anesthesia Medical Group Inc.
• Apple Valley Christian Centers
• Apple Valley Eyewear, Inc.
• Apple Valley Head Start
• Apple Valley Periodontal Associates
• Apple Valley Retirement Inc
• Apple Valley Unified School District
• Apple Valley Urgent Care

• Optometrist in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; 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.