Provider Demographics
NPI:1033704507
Name:FIRST OPTOMETRIC CARE OF NORTHERN CALIFORNIA PC
Entity Type:Organization
Organization Name:FIRST OPTOMETRIC CARE OF NORTHERN CALIFORNIA PC
Other - Org Name:EASTGATE OPTOMETRY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ERNEST
Authorized Official - Last Name:WINNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-847-3051
Mailing Address - Street 1:3333 QUALITY DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7985
Mailing Address - Country:US
Mailing Address - Phone:916-858-5656
Mailing Address - Fax:
Practice Address - Street 1:11893 VALLEY VIEW ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92845-1236
Practice Address - Country:US
Practice Address - Phone:714-373-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-05
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty