Provider Demographics
NPI:1134663842
Name:AUBURN EYE CARE ASSOCIATES
Entity Type:Organization
Organization Name:AUBURN EYE CARE ASSOCIATES
Other - Org Name:AUBURN EYE CARE ASSOCIATES OPTOMETRY COLFAX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BELAJIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-885-6241
Mailing Address - Street 1:3211 FORTUNE CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95602-9245
Mailing Address - Country:US
Mailing Address - Phone:530-885-6241
Mailing Address - Fax:530-885-0144
Practice Address - Street 1:333 S AUBURN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:COLFAX
Practice Address - State:CA
Practice Address - Zip Code:95713-9778
Practice Address - Country:US
Practice Address - Phone:530-346-2269
Practice Address - Fax:530-346-2593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-14
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT8552TPG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHB690AMedicare PIN