Provider Demographics
NPI:1346411022
Name:EYECARE SOLUTIONS INC
Entity Type:Organization
Organization Name:EYECARE SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-759-4684
Mailing Address - Street 1:477 N EL CAMINO REAL STE C202
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1332
Mailing Address - Country:US
Mailing Address - Phone:760-631-3500
Mailing Address - Fax:760-941-7448
Practice Address - Street 1:477 N EL CAMINO REAL STE C202
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1332
Practice Address - Country:US
Practice Address - Phone:760-631-3500
Practice Address - Fax:760-941-7448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41008207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA92582BMedicaid
CAWOP10288BMedicaid
CAWOP12300BMedicaid
I28325Medicare UPIN
I15372Medicare UPIN
U97852Medicare UPIN
CAWOP10288BMedicaid
CAWOP12300BMedicaid
CAWOP12300AMedicare PIN
CAWA41008DMedicare PIN
U65999Medicare UPIN
CAWA92582BMedicaid