Heritage Eye Associates

LBN: Kenneth V. Miselis, M.D. Inc.
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 Other Service Providers / Specialist, which is considered as the primary health care specialty. Kenneth V. Miselis, M.D. Inc. can be contacted via phone (209) 465-5933, or through Miselis, Kenneth Victor via phone (209) 465-5933.

Contact Information

Primary practice address
445 W Poplar St Stockton CA 95203-2426
Phone: (209) 465-5933
Fax: (209) 465-2562
Website:
Map and Directions
Authorized official contact:
Name: Miselis, Kenneth Victor Doctor of Medicine (MD)
Phone: (209) 465-5933

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X G502810 California

Profile Details

NPI number 1962413740
LBN Legal business name Kenneth V. Miselis, M.D. Inc.
DBA Doing business as Heritage Eye Associates
Authorized official Miselis, Kenneth Victor Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 10th, 2006
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 1962413740 NPPES
California Other 180033368 RAILROAD MEDICARE
California MEDICAID GR0050600 RAILROAD MEDICARE

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