Provider Demographics
NPI:1316005671
Name:SOLANO EYECARE OPTOMETRIC PROFESSIONALS
Entity Type:Organization
Organization Name:SOLANO EYECARE OPTOMETRIC PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:510-526-3937
Mailing Address - Street 1:1051 SOLANO AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-1650
Mailing Address - Country:US
Mailing Address - Phone:510-526-3937
Mailing Address - Fax:510-526-6133
Practice Address - Street 1:1051 SOLANO AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-1650
Practice Address - Country:US
Practice Address - Phone:510-526-3937
Practice Address - Fax:510-526-6133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFNP 2934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ26900ZMedicare PIN
CA0632180001Medicare NSC