Pacific Vision Medical Center

LBN: Pacific Vision Medical Center
Pacific Vision Medical Center is an health care organization with primary practice located at 515 E Washington Blvd , Crescent City CA 95531-8342. The organization recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Allopathic & Osteopathic Physicians / Ophthalmology, Suppliers / Eyewear Supplier (Equipment, not the service). Allopathic & Osteopathic Physicians / Ophthalmology is the primary health care specialty. Pacific Vision Medical Center can be contacted via phone (707) 465-2020, or through Eninger, Larry A via phone (707) 465-2020.

Contact Information

Primary practice address
515 E Washington Blvd Crescent City CA 95531-8342
Fax: (707) 465-6252
Website:
Authorized official contact:
Name: Eninger, Larry A Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ZZZ28910Z California
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X ZZZ28910Z California
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X 0534820001 California

Profile Details

NPI number 1346399433
LBN Legal business name Pacific Vision Medical Center
DBA Doing business as
Authorized official Eninger, Larry A Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 9th, 2007
Last updated Jun 29th, 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 1346399433 NPPES
California MEDICAID GR0052190

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