Provider Demographics
NPI:1710063730
Name:AUBURN FAMILY OPTOMETRY, INC.
Entity Type:Organization
Organization Name:AUBURN FAMILY OPTOMETRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:VERNE
Authorized Official - Last Name:ALLGEIER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:530-888-0670
Mailing Address - Street 1:3133 PROFESSIONAL DRIVE
Mailing Address - Street 2:SUITE 14
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603
Mailing Address - Country:US
Mailing Address - Phone:530-888-0670
Mailing Address - Fax:530-888-8652
Practice Address - Street 1:3133 PROFESSIONAL DR
Practice Address - Street 2:SUITE 14
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-2463
Practice Address - Country:US
Practice Address - Phone:530-888-0670
Practice Address - Fax:530-888-8652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 8316 TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT09965Medicare UPIN
CAU18468Medicare UPIN
CAT10475Medicare UPIN
U31015Medicare UPIN
CA5953760001Medicare NSC