Provider Demographics
NPI:1669471835
Name:JONATHAN SAVELL, MD., INC.
Entity Type:Organization
Organization Name:JONATHAN SAVELL, MD., INC.
Other - Org Name:VALLEY EYECARE CENTER MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:SAVELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-460-5000
Mailing Address - Street 1:5575 W LAS POSITAS BLVD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-5801
Mailing Address - Country:US
Mailing Address - Phone:925-460-5000
Mailing Address - Fax:925-460-5040
Practice Address - Street 1:5575 W. LAS POSITAS BLVD.
Practice Address - Street 2:SUITE 240
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-5802
Practice Address - Country:US
Practice Address - Phone:925-460-5000
Practice Address - Fax:925-460-5040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA152W00000X, 207W00000X
332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G160910Medicaid
CAA39700Medicare UPIN
CA0464700001Medicare NSC
ZZZ15067ZMedicare ID - Type Unspecified