IMPERIAL VALLEY OPTOMETRIC CORPORATION (NPI# 1043588346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043588346 |
| Entity Type | Organization |
| Organization Name | IMPERIAL VALLEY OPTOMETRIC CORPORATION |
| Other Organization Name | OPTOM EYES VISION CARE |
| Practice Address |
5638 Mission Center Rd Ste 103 San Diego CA 92108-4348 |
| Mailing Address |
3451 S Dogwood Ave Ste 1334 El Centro CA 92243 |
| Practice Telephone | 6192952900 |
| Practice Fax Number | 8882105799 |
| Mailing Telephone | 7603363003 |
| Mailing Fax Number | 8882105799 |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2011-12-06 |
| Authorized Official Name | DR. MAY C TAM (VICE PRESIDENT) |
| Authorized Official Telephone | 7603363003 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GSD005600 | 05 |
| Other Name | Type Code |
|---|---|
| Optom Eyes Vision Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497032783 | Imperial Valley Optometric Corporation | Optometrist | 700 Imperial Ave, El Centro, CA 92243-9140 | 2011-11-15 |
| 1780838649 | Imperial Valley Optometric Corporation | Optometrist | 1113 Imperial Ave W, Suite 103, Calexico, CA 92231-4808 | 2008-11-05 |
| 1508010463 | Imperial Valley Optometric Corporation | Optometrist | 1503 N Imperial Ave, Suite 103, El Centro, CA 92243-6301 | 2008-11-05 |
| Street Address |
5638 MISSION CENTER RD STE 103 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92108-4348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437225091 | Stuart Tani | Dentist | 5638 Mission Center Rd, #104, San Diego, CA 92108-4348 | 2006-11-27 |
| 1174076004 | Grace Catherine Fedor | Dentist | 5638 Mission Center Rd, Ste 107, San Diego, CA 92108-4348 | 2016-07-27 |
| 1689002289 | Rina Patel | Dentist | 5638 Mission Center Rd, Suite 107, San Diego, CA 92108-4348 | 2013-10-17 |
| 1366701096 | Lance Rygg Professional Dental Corporation | Dentist | 5638 Mission Center Rd, Suite 107, San Diego, CA 92108-4348 | 2012-05-15 |
| 1023216751 | San Diego Specialty Care | Dentist | 5638 Mission Center Rd, #105, San Diego, CA 92108-4348 | 2007-07-03 |
| 1336366616 | S. T. Tani, A Dental Corporation | Dentist | 5638 Mission Center Rd, #104, San Diego, CA 92108-4348 | 2007-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902801 | Keri Castaneda | Behavior Technician | 025 Camino Del Rio South Suite 101, San Diego, CA 92108 | 2020-11-06 |
| 1457963738 | Diyana Giorgees | Case Manager/Care Coordinator | 5005 Texas Street, St. 203, San Diego, CA 92108 | 2020-08-19 |
| 1780211896 | Lori Mildred Jerman | Marriage & Family Therapist | Healthy Minds Counseling Services, 1455 Frazee Road, Suite 880, San Diego, CA 92108 | 2020-03-26 |
| 1285260737 | Demetrius Anderson | Counselor | Telecare Corporation Ihot, 1660 Hotel Circle North, Suite 101, San Deigo, CA 92108 | 2020-03-17 |
| 1033742465 | Dasc Medical Inc | Durable Medical Equipment & Medical Supplies | 5520 Gill Village Way, 907, San Diego, CA 92108 | 2020-02-13 |
| 1508401092 | Chanda Denee Kizer | Marriage & Family Therapist | 3517 Camino Del Rio N, Suite 407, San Diego, CA 92108 | 2019-11-08 |
| 1225695562 | Jenna Rose Shurer | Nurse Practitioner | 5030 Camino De La Siesla Ste 106, San Diego, CA 92108 | 2019-05-22 |
| 1952967812 | Martha Kebede Mekonen | Chiropractor | 2667 Camino Del Rio South, Suite #313, San Diego, CA 92108 | 2019-05-16 |
| 1053886135 | Andrea Jiselly Munoz | Behavior Technician | 3505 Camino Del Rio South, Suite 200, San Diego, CA 92108 | 2018-10-04 |
| 1386128916 | Sarah Elisabeth Smith | Counselor | 7575 Metropolitan Dr., San Diego, CA 92108 | 2018-09-19 |
| Find all providers in zip 92108 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720699432 | Emily Thai | Optometrist | 10994 W Ocean Air Dr Apt 286, San Diego, CA 92130-4635 | 2020-08-14 |
| 1841800018 | Luminoptix Optometry | Optometrist | 655 Saturn Blvd Ste H, San Diego, CA 92154-4734 | 2020-08-03 |
| 1427673680 | Courtney Lynn Cape | Optometrist | 4353 La Jolla Village Dr Ste H-20, San Diego, CA 92122-1242 | 2020-06-13 |
| 1073137691 | Charles Tu | Optometrist | 2150 Pacific Beach Dr Apt 234, San Diego, CA 92109-5639 | 2020-05-29 |
| 1538796578 | Wilson Phu | Optometrist | 3345 Rosecrans St Ste B, San Diego, CA 92110-4225 | 2020-03-26 |
| 1346874971 | Florena Culas | Optometrist | 7477 Goode St, San Diego, CA 92139-3931 | 2020-02-22 |
| 1235786633 | Courtney Hongo | Optometrist | San Diego Va 3350 La Jolla Village Dr #1125, San Diego, CA 92161-0001 | 2019-08-20 |
| 1467012740 | Luis G. Perez-rivera Od Optometric Corporation | Optometrist | 11134 Rancho Carmel Dr Ste 102, San Diego, CA 92128-4671 | 2019-06-18 |
| 1063972438 | Fabian Luna Od, Inc | Optometrist | 9855 Erma Rd Ste 130, San Diego, CA 92131-1092 | 2019-03-22 |
| 1790249563 | Imperial Beach Optometric Corporation | Optometrist | 1555 Palm Ave Ste A2, San Diego, CA 92154-1012 | 2019-01-25 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.