Provider Demographics
NPI:1508140062
Name:VISIONCARE OF CALIFORNIA
Entity Type:Organization
Organization Name:VISIONCARE OF CALIFORNIA
Other - Org Name:STERLING VISIONCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHASHATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-454-4547
Mailing Address - Street 1:1095 ROSEVILLE SQ
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-2809
Mailing Address - Country:US
Mailing Address - Phone:916-782-9985
Mailing Address - Fax:916-782-9987
Practice Address - Street 1:1095 ROSEVILLE SQ
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-2809
Practice Address - Country:US
Practice Address - Phone:916-782-9985
Practice Address - Fax:916-782-9987
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMERGING VISION INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty