Wild Iris Optometric Group
LBN: Laurie Chalkin
Wild Iris Optometric Group is an health care organization with primary practice located at 3717 Castro Valley Blvd , Castro Valley CA 94546-4405. The organization recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Vision Therapy. Eye and Vision Services Providers / Low Vision Rehabilitation is the primary health care specialty.
Laurie Chalkin can be contacted via phone (510) 538-3937, or through Chaikin, Laurie Ruth via phone (510) 538-3937.
Contact Information
Primary practice address
3717 Castro Valley Blvd
Castro Valley CA 94546-4405
Phone: (510) 538-3937
Fax:
Website:
Authorized official contact:
Name: Chaikin, Laurie Ruth Doctor of Optometry (OD)
Phone: (510) 538-3937
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | 10195 | California |
| Eye and Vision Services Providers / Vision Therapy | 152WV0400X | 7597 | California |
Profile Details
| NPI number | 1679641203 |
|---|---|
| LBN Legal business name | Laurie Chalkin |
| DBA Doing business as | Wild Iris Optometric Group |
| Authorized official | Chaikin, Laurie Ruth Doctor of Optometry (OD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 1st, 2006 |
| Last updated | Jul 22nd, 2008 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679641203 | NPPES |
| California | MEDICAID | SD0101950 |
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