Provider Demographics
NPI:1821177858
Name:ALLGEIER, JEFFREY VERNE (OD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:VERNE
Last Name:ALLGEIER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3133 PROFESSIONAL DR STE 14
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-2463
Mailing Address - Country:US
Mailing Address - Phone:530-888-0670
Mailing Address - Fax:530-888-8652
Practice Address - Street 1:3133 PROFESSIONAL DR STE 14
Practice Address - Street 2:
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
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 7115 TPA152W00000X, 156FC0801X, 152WS0006X, 152WP0200X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens Fitter
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT10475Medicare UPIN