Provider Demographics
NPI:1720131055
Name:PATRICIA L. AUSTIN, MD, INC.
Entity Type:Organization
Organization Name:PATRICIA L. AUSTIN, MD, INC.
Other - Org Name:PACIFIC EYE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-945-8188
Mailing Address - Street 1:1270 ARROYO WAY
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-4216
Mailing Address - Country:US
Mailing Address - Phone:925-945-8188
Mailing Address - Fax:925-945-0360
Practice Address - Street 1:1270 ARROYO WAY
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4216
Practice Address - Country:US
Practice Address - Phone:925-945-8188
Practice Address - Fax:925-945-0360
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATRICIA L. AUSTIN, MD, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-19
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
152W00000X
CAA29698207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA25852Medicare UPIN
CA0949120001Medicare NSC
CAA296980Medicare ID - Type Unspecified