Provider Demographics
NPI:1710173844
Name:C. TROY ALLRED, O.D., INC.
Entity Type:Organization
Organization Name:C. TROY ALLRED, O.D., INC.
Other - Org Name:ALLRED FAMILY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:TROY
Authorized Official - Last Name:ALLRED
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:714-526-5515
Mailing Address - Street 1:1601 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-4015
Mailing Address - Country:US
Mailing Address - Phone:714-526-5515
Mailing Address - Fax:714-526-5384
Practice Address - Street 1:1601 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831
Practice Address - Country:US
Practice Address - Phone:714-526-5515
Practice Address - Fax:714-526-5384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT7319152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWY061Medicare PIN
CA0825590001Medicare NSC