Heritage Eye Associates

LBN: Heritage Eye Associates
Heritage Eye Associates is an health care organization with primary practice located at 445 W Poplar St , Stockton CA 95203-2426. The organization recently has only one registered license in Suppliers / Durable Medical Equipment & Medical Supplies, which is considered as the primary health care specialty. Heritage Eye Associates can be contacted via phone (209) 465-5933, or through Miselis, Kenneth V via phone (209) 465-5562.

Contact Information

Primary practice address
445 W Poplar St Stockton CA 95203-2426
Phone: (209) 465-5933
Fax: (209) 465-2568
Website:
Map and Directions
Authorized official contact:
Name: Miselis, Kenneth V Doctor of Medicine (MD)
Phone: (209) 465-5562

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X G502810 California

Profile Details

NPI number 1972636397
LBN Legal business name Heritage Eye Associates
DBA Doing business as
Authorized official Miselis, Kenneth V Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 14th, 2007
Last updated Jun 17th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972636397 NPPES
California Other 076183001 MEDICARE DMERC

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