Elite Eyecare Medical Group a Medical Corporation

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

ELITE EYECARE MEDICAL GROUP A MEDICAL CORPORATION

Doing business as

Kendall-Shepard Optical

Practice address

425 W Central Ave Ste 102
Lompoc, CA 93436

Phone

(805) 736-2020

Fax

(805) 737-1733

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Kendall, OD

Title

Ceo

Phone

(805) 736-2020

Specialties & licenses 1

Addresses

Other names 1

• Kendall-Shepard Optical Doing business as

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538352000000",
    "number": "1952456824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 E STOWELL RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547001",
            "telephone_number": "805-925-2637",
            "fax_number": "805-347-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W CENTRAL AVE STE 102",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "93436",
            "telephone_number": "805-736-2020",
            "fax_number": "805-737-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE EYECARE MEDICAL GROUP A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2018-10-01",
        "status": "A",
        "authorized_official_last_name": "KENDALL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "805-736-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kendall-Shepard Optical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kendall-Shepard Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Edward M. Mikowicz D.D.S., Inc.
• Dale Ethan Ekstrum, MD
• David S Elam, MA CCC SLP
• Nancy Revelli Elam, MA CCC SLP
• Elite Eyecare Medical Group a Medical Corporation (Kendall Optometry)
• Emergent Learning LLC
• Jenna-Brie Engelke
• Holly Marie Engler
• Janice Catherine Englert, M.A., LMFT
• Adriana Enriquez, PPS

• Eyewear Supplier in Lompoc, CA
• Providers in Lompoc, CA by specialty
• Eyewear Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; 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.