Provider Demographics
NPI:1023392586
Name:VISIONCARE OF CALIFORNIA INC.
Entity Type:Organization
Organization Name:VISIONCARE OF CALIFORNIA INC.
Other - Org Name:STERLING VISIONCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHASHATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-454-4647
Mailing Address - Street 1:2320 MIDWAY DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-5017
Mailing Address - Country:US
Mailing Address - Phone:707-526-2020
Mailing Address - Fax:707-526-2032
Practice Address - Street 1:2320 MIDWAY DR
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-5017
Practice Address - Country:US
Practice Address - Phone:707-526-2020
Practice Address - Fax:707-526-2032
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMERGING VISION INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty