Organization · NPI-2

Elite Eyecare Medical Group A Medical Corporation

Ophthalmology · Santa Maria, CA

NPI number1245548023
StatusActive
Last updated in NPPESOct 1, 2018

Details

NPI
1245548023
Entity type
Organization (NPI-2)
Legal business name
Elite Eyecare Medical Group A Medical Corporation
Organization subpart
No
Enumeration date
Sep 15, 2010
Last updated
Oct 1, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207W00000X Ophthalmology––Yes

Other names

  • Shepard Eye Center (Doing Business As)

Practice location

1429 S Broadway
Santa Maria, CA 93454

Phone 805-925-9575 · Fax 805-347-0033

Mailing address

910 E Stowell Rd
Santa Maria, CA 93454-7001

Phone 805-925-2637 · Fax 805-347-0033

Authorized official

Kenneth R Kendall
Ceo
8059222637

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