Provider Demographics
NPI:1578777041
Name:SALATINI EYE CARE, LLC
Entity Type:Organization
Organization Name:SALATINI EYE CARE, LLC
Other - Org Name:KANSAS VISION CARE,LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARZANEH
Authorized Official - Middle Name:
Authorized Official - Last Name:SALATINI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:949-416-4734
Mailing Address - Street 1:27881 LA PAZ RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-3933
Mailing Address - Country:US
Mailing Address - Phone:949-416-4734
Mailing Address - Fax:
Practice Address - Street 1:27881 LA PAZ RD
Practice Address - Street 2:SUITE G
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-3933
Practice Address - Country:US
Practice Address - Phone:949-416-4734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
152W00000X
CA14871152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200423010AMedicaid
KS200423010AMedicaid
8006334227Medicare UPIN