Sun City Vision Clinic Optometry

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT15133 Issued in CA

Legal business name

SUN CITY VISION CLINIC OPTOMETRY

Practice address

27830 Bradley Rd
Sun City, CA 92586-2201

Phone

(951) 672-4971

Fax

(951) 672-4083

NPI assigned

Nov 2, 2015

Last updated

Nov 2, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lysle Shaw-McMinn, O.D.NPI 1720481641

Title

Owner/Optometrist

Phone

(951) 990-7765

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lysle Shaw-McMinn, O.D.

  • Optometrist
  • Riverside, CA
  • NPI 1720481641
  Authorized official Same address or phone

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

{
    "created_epoch": "1446422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1952774788",
    "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": "925862201",
            "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 OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-02",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "SHAW-MCMINN",
        "authorized_official_first_name": "LYSLE",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "951-990-7765",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT15133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• 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 Nov 2, 2015; 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.