San Diego Eyecor, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SAN DIEGO EYECOR, LLC

Practice address

3939 3Rd Ave
San Diego, CA 92103-3002

Phone

(619) 296-8525

Fax

(619) 692-0229

NPI assigned

Jul 19, 2006

Organization subpart

No

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

Authorized official

Name

Clifton Chad Bazhaw

Title

Chief Revinue Officer

Phone

(214) 893-0471

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

San Diego Eye Cor IncCCN 05C0001011

Medicare certification status

ActiveFrom the Provider of Services file

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Pacific Eye Institute a Medical Group Inc

  • Ambulatory Surgical Clinic/Center
  • Upland, CA
  • NPI 1407932619

  Member Of

  NPD member

Practitioners 1

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

• Robert Neal Fabricant, M.D.

  • Ophthalmology Physician
  • Jupiter, FL
  • NPI 1881615466
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772409600000",
    "number": "1922027176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 3RD AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033002",
            "telephone_number": "800-765-2737",
            "fax_number": "619-291-6577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 3RD AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033002",
            "telephone_number": "619-296-8525",
            "fax_number": "619-692-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO EYECOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A",
        "authorized_official_last_name": "BAZHAW",
        "authorized_official_first_name": "CLIFTON",
        "authorized_official_middle_name": "CHAD",
        "authorized_official_title_or_position": "CHIEF REVINUE OFFICER",
        "authorized_official_telephone_number": "214-893-0471"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• San Diego Emergency Physicians, Inc.
• San Diego Endoscopy Center
• San Diego Eye and Face
• San Diego Eye Bank
• San Diego Eye Group, Inc.
• San Diego Face and Neck Specialties, Inc
• San Diego Family Acupuncture
• San Diego Family Care (Mid City Community Clinic Adults)
• San Diego Family Care (Linda Vista Health Care Center)
• San Diego Family Care (Mid-City Community Clinic)

• Ambulatory Surgical Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.