ELITE EYECARE MEDICAL GROUP A MEDICAL CORPORATION (NPI# 1437117231) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437117231 |
| Entity Type | Organization |
| Organization Name | ELITE EYECARE MEDICAL GROUP A MEDICAL CORPORATION |
| Other Organization Name | KENDALL OPTOMETRY |
| Practice Address |
425 W Central Ave Ste 102 Lompoc CA 93436 |
| Mailing Address |
910 E Stowell Rd Santa Maria CA 93454-7001 |
| Practice Telephone | 8057362020 |
| Practice Fax Number | 8057371733 |
| Mailing Telephone | 8059252637 |
| Mailing Fax Number | 8053470033 |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2018-10-10 |
| Authorized Official Name | STEPHEN BYLSMA (PRESIDENT) |
| Authorized Official Telephone | 8059252637 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians | ||
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0086920 | 05 | |
| CA | BLUE SHIELD OF CA | ZZZ61060Z | 01 |
| CA | GSD004611 | 05 |
| Other Name | Type Code |
|---|---|
| Kendall Optometry | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659857928 | Elite Eyecare Medical Group A Medical Corporation | Eyewear Supplier (Equipment, not the service) | 2040 Viborg Rd Ste 240, Solvang, CA 93463 | 2018-07-19 |
| 1760982300 | Elite Eyecare Medical Group A Medical Corporation | Ophthalmology | 437 Marsh St, San Luis Obispo, CA 93401 | 2018-02-20 |
| 1356763759 | Elite Eyecare Medical Group A Medical Corporation | Ophthalmology | 2040 Viborg Rd, #240, Solvang, CA 93463 | 2014-01-20 |
| 1245548023 | Elite Eyecare Medical Group A Medical Corporation | Ophthalmology | 1429 S Broadway, Santa Maria, CA 93454 | 2010-09-15 |
| 1710216957 | Elite Eyecare Medical Group A Medical Corporation | Ophthalmology | 1245 Broad St, San Luis Obispo, CA 93401 | 2009-12-17 |
| 1578618252 | Elite Eyecare Medical Group A Medical Corporation | Eyewear Supplier (Equipment, not the service) | 910 E Stowell Rd, Santa Maria, CA 93454 | 2007-01-24 |
| 1952456824 | Elite Eyecare Medical Group A Medical Corporation | Eyewear Supplier (Equipment, not the service) | 425 W Central Ave Ste 102, Lompoc, CA 93436 | 2007-01-23 |
| Street Address |
425 W CENTRAL AVE STE 102 |
| City | LOMPOC |
| State | CA |
| Zip Code | 93436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700889532 | Kenneth R. Kendall | Optometrist | 425 W Central Ave Ste 102, Lompoc, CA 93436-2806 | 2005-05-24 |
| 1952456824 | Elite Eyecare Medical Group A Medical Corporation | Eyewear Supplier (Equipment, not the service) | 425 W Central Ave Ste 102, Lompoc, CA 93436 | 2007-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671498 | Bonnie O'brien | Technician | 4174 Sirius Avenue, Lompoc, CA 93436 | 2019-10-21 |
| 1043734056 | Stevens Life Chiropractic, PC | Chiropractor | 217-a West Central Ave, Lompoc, CA 93436 | 2017-08-01 |
| 1548621014 | Kimberly Gaynell Wiley | Home Health Aide | 610 East Pine St #34, Lompoc, CA 93436 | 2016-03-11 |
| 1386017960 | Marcos Paul Cline | Counselor | 117 North 'b' Street, Lompoc, CA 93436 | 2015-11-04 |
| 1487045324 | Angela Rose Robinson | Case Manager/Care Coordinator | 113 North H Street, Suite F, Lompoc, CA 93436 | 2015-02-13 |
| 1851795751 | Alina Staniger | Counselor | 604 W Ocean, Lompoc, CA 93436 | 2014-10-21 |
| 1154750560 | Lompoc Valley Medical Center | General Acute Care Hospital | 303 South C Street, Lompoc, CA 93436 | 2013-11-06 |
| 1598191488 | David Lewis Mcaninch Iv | Dentist | 1111 East Ocean Avenue, Suite 9, Lompoc, CA 93436 | 2013-09-24 |
| 1336407048 | Pamela Jordan | Counselor | 110 S. 'c' St. Ste. A, Family Service Agency, Lompoc, CA 93436 | 2012-05-01 |
| 1316220874 | Zillah J. Hodgkins | Counselor | 513 N G St, Lompoc, CA 93436 | 2011-09-21 |
| Find all providers in zip 93436 | ||||
| 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 |
|---|---|---|---|---|
| 1235412420 | Clear Vision Optometry | Optometrist | 415 E Ocean Ave Ste B, Lompoc, CA 93436-6839 | 2011-09-23 |
| 1669583738 | Daniel R Taketa | Optometrist | 611 E Ocean Ave, Lompoc, CA 93436-6914 | 2006-08-31 |
| 1881627768 | Sidney John Wiley | Optometrist | 1305 N H St, Suite E, Lompoc, CA 93436-8138 | 2006-07-07 |
| 1811990633 | Peter N. Brudner | Optometrist | 425 W Central Ave, Lompoc, CA 93436-2805 | 2005-05-24 |
| 1700889532 | Kenneth R. Kendall | Optometrist | 425 W Central Ave Ste 102, Lompoc, CA 93436-2806 | 2005-05-24 |
| 1487271243 | David Earl Bowin | Optometrist | 425 W Central Ave, Lompoc, CA 93436-2805 | 2020-06-28 |
| 1003321845 | Steven M Kleen Optometric Corporation | Optometrist | 701 W Central Ave, Lompoc, CA 93436-2829 | 2017-12-01 |
| 1104371343 | Pinhkeo Southaphanh, O.d., Inc. | Optometrist | 415 E Ocean Ave Ste B, Lompoc, CA 93436-6839 | 2016-08-17 |
| 1376924779 | Steven Matthew Kleen | Optometrist | 701 W Central Ave, Lompoc, CA 93436-2829 | 2015-06-11 |
| 1063649564 | Daniel R. Taketa | Optometrist | 611 E Ocean Ave, Lompoc, CA 93436-6914 | 2009-06-11 |
| Find all providers in LOMPOC | ||||
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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.