Sun City Vision Clinic

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT6553T Issued in CA

Legal business name

SUN CITY VISION CLINIC

Practice address

27830 Bradley Rd.
Sun City, CA 92586-2201

Phone

(951) 672-4971

Fax

(951) 672-4083

NPI assigned

Apr 27, 2007

Organization subpart

Yes

Parent organization

SUN CITY VISION CLINICAs reported in NPPES

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

Authorized official

Name

Dr. Peter G Shaw-MC Minn, O.D.

Title

Owner

Phone

(951) 672-4971

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sun City Vision Clinic Doing business as

Part of

Woodcrest Vision Center

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221091200000",
    "number": "1942420120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27830 BRADLEY RD.",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "92586",
            "telephone_number": "951-672-4971",
            "fax_number": "951-672-4083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27830 BRADLEY RD.",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925862201",
            "telephone_number": "951-672-4971",
            "fax_number": "951-672-4083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN CITY VISION CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUN CITY VISION CLINIC",
        "enumeration_date": "2007-04-27",
        "last_updated": "2008-09-11",
        "status": "A",
        "authorized_official_last_name": "SHAW-MC MINN",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-672-4971",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT6553T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ81412Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sun City Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David C Stanford, MD
• Stephanus Ong MD Inc
• Sun City Cardiology Medical Center, Inc.
• Sun City Hearing Service
• Sun City Pharmacy
• Sun City Vision Clinic Optometry
• Superior Hearing Aid Service
• Susan M. Danek MD a Professional Medical Corporation
• T D Nguyen, MD, Inc
• Christine Taufik

• Optometrist in Sun City, CA
• Providers in Sun City, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; 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.