Provider Demographics
NPI:1720488802
Name:VISION CARE CENTER, A MEDICAL GROUP INC
Entity Type:Organization
Organization Name:VISION CARE CENTER, A MEDICAL GROUP INC
Other - Org Name:EYE-Q
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-486-2000
Mailing Address - Street 1:7075 N SHARON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3329
Mailing Address - Country:US
Mailing Address - Phone:559-486-2000
Mailing Address - Fax:559-256-8575
Practice Address - Street 1:726 N MEDICAL CENTER DR E STE 101
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6882
Practice Address - Country:US
Practice Address - Phone:559-486-2000
Practice Address - Fax:559-256-8575
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VISION CARE CENTER, A MEDICAL GROUP INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-26
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ51516ZMedicare PIN