Provider Demographics
NPI:1912107988
Name:A. SAUL OD & DAVID J. BARRETO OD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:A. SAUL OD & DAVID J. BARRETO OD A PROFESSIONAL CORPORATION
Other - Org Name:WINCHESTER OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:A. SAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:408-244-8700
Mailing Address - Street 1:1101 S WINCHESTER BLVD STE E156
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3903
Mailing Address - Country:US
Mailing Address - Phone:408-244-8700
Mailing Address - Fax:408-244-9560
Practice Address - Street 1:1101 S WINCHESTER BLVD STE E156
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3903
Practice Address - Country:US
Practice Address - Phone:408-244-8700
Practice Address - Fax:408-244-9560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3537152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ83645ZMedicare PIN
CA0322800001Medicare NSC