Provider Demographics
NPI:1467599597
Name:VISIONCARE OF CALIFORNIA
Entity Type:Organization
Organization Name:VISIONCARE OF CALIFORNIA
Other - Org Name:STERLING VISIONCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHASHATI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:800-454-4647
Mailing Address - Street 1:9625 BLACK MOUNTAIN RD
Mailing Address - Street 2:SUITE 311
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-4564
Mailing Address - Country:US
Mailing Address - Phone:800-454-4647
Mailing Address - Fax:858-831-0225
Practice Address - Street 1:140 BATTERY ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-4903
Practice Address - Country:US
Practice Address - Phone:415-421-2020
Practice Address - Fax:415-421-6072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADMHC-9330287152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty