Provider Demographics
NPI:1699854158
Name:SIERRA EYECARE ASSOCIATES
Entity Type:Organization
Organization Name:SIERRA EYECARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRONK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:209-223-2020
Mailing Address - Street 1:817 COURT ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:JACKSON
Mailing Address - State:CA
Mailing Address - Zip Code:95642-2156
Mailing Address - Country:US
Mailing Address - Phone:209-223-2020
Mailing Address - Fax:209-223-2046
Practice Address - Street 1:817 COURT ST
Practice Address - Street 2:SUITE 10
Practice Address - City:JACKSON
Practice Address - State:CA
Practice Address - Zip Code:95642-2156
Practice Address - Country:US
Practice Address - Phone:209-223-2020
Practice Address - Fax:209-223-2046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACPS5166OtherMEDICARE RAILROAD
CA0297050001Medicare NSC
ZZZ22847ZMedicare PIN