Provider Demographics
NPI:1477509560
Name:SILICON VALLEY EYECARE OPTOMETRY AND CONTACT LENSES
Entity Type:Organization
Organization Name:SILICON VALLEY EYECARE OPTOMETRY AND CONTACT LENSES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCBRIDE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:408-296-0511
Mailing Address - Street 1:770 SCOTT BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-6927
Mailing Address - Country:US
Mailing Address - Phone:408-296-0511
Mailing Address - Fax:408-296-1647
Practice Address - Street 1:770 SCOTT BLVD
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-6927
Practice Address - Country:US
Practice Address - Phone:408-296-0511
Practice Address - Fax:408-296-1647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2007-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFNP 3152152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAYYY48675YMedicaid
CA0625010001Medicare NSC
CAYYY49956YMedicare PIN