Provider Demographics
NPI:1922442680
Name:HELMUS OPTOMETRY
Entity Type:Organization
Organization Name:HELMUS OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SASHA
Authorized Official - Middle Name:W
Authorized Official - Last Name:BENTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-758-2122
Mailing Address - Street 1:353 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-4607
Mailing Address - Country:US
Mailing Address - Phone:530-758-2122
Mailing Address - Fax:530-758-1448
Practice Address - Street 1:353 2ND ST
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-4607
Practice Address - Country:US
Practice Address - Phone:530-758-2122
Practice Address - Fax:530-758-1448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-24
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA13792TLG152W00000X
CAOPT 7215 TPA152W00000X
CAOPT 8488 TPA152W00000X
CAOPT 15337 TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty