SPECTRUM EYE PHYSICIANS, A MEDICAL CORPORATION (NPI# 1790036101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790036101 |
| Entity Type | Organization |
| Organization Name | SPECTRUM EYE PHYSICIANS, A MEDICAL CORPORATION |
| Other Organization Name | SPECTRUM EYE PHYSICIANS |
| Practice Address |
393 Blossom Hill Rd Suite 265 San Jose CA 95123-1652 |
| Mailing Address |
10300 S De Anza Blvd Suite A Cupertino CA 95014-3030 |
| Practice Telephone | 4082277122 |
| Practice Fax Number | 4082277722 |
| Mailing Telephone | 4082533083 |
| Mailing Fax Number | 4082532965 |
| Enumeration Date | 2012-09-25 |
| Last Update Date | 2012-09-25 |
| Authorized Official Name | MR. MICHAEL J. WILHELM (ADMINISTRATOR/CONTROLLER) |
| Authorized Official Telephone | 4082527310 |
| Authorized Official Credential | C.O.E. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | A24242 | CA | Allopathic & Osteopathic Physicians |
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | 97-675847 00004 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| Spectrum Eye Physicians | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487601522 | Spectrum Eye Physicians, A Medical Corporation | Optometrist | 10300 S De Anza Blvd, Suite A, Cupertino, CA 95014-3030 | 2006-05-27 |
| 1376894782 | Spectrum Eye Physicians, A Medical Corporation | Optometrist | 431 Monterey Ave, Suite 3, Los Gatos, CA 95030-5319 | 2012-09-25 |
| 1891046298 | Spectrum Eye Physicians, A Medical Corporation | Optometrist | 2577 Samaritan Dr, Suite 740, San Jose, CA 95124-4100 | 2012-09-25 |
| Street Address |
393 BLOSSOM HILL RD SUITE 265 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95123-1652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154392009 | Satellite Healthcare Inc | Clinic/Center | 393 Blossom Hill Rd, Ste 110, San Jose, CA 95123-1652 | 2006-01-30 |
| 1770951915 | Tri-county Vascular Care, LLC | Clinic/Center | 393 Blossom Hill Rd, San Jose, CA 95123-1652 | 2015-09-03 |
| 1790178317 | Stephen Kenneth Boniface | Nurse Practitioner | 393 Blossom Hill Rd, Suite 390b, San Jose, CA 95123-1652 | 2015-03-05 |
| 1730525411 | James L Andrews M D A Professional Corporation | Clinic/Center | 393 Blossom Hill Rd, Suite 301, San Jose, CA 95123-1652 | 2013-05-21 |
| 1013352475 | Leah R Johnson | Pharmacist | 393 Blossom Hill Rd, San Jose, CA 95123-1652 | 2013-04-30 |
| 1225339211 | C. Desmond Gunatilaka, M.d., Inc. | Clinic/Center | 393 Blossom Hill Rd, Suite 260 B, San Jose, CA 95123-1652 | 2010-11-08 |
| 1225366990 | Penelope Wells Schenkkan | Behavioral Analyst | 393 Blossom Hill Rd, San Jose, CA 95123-1652 | 2009-11-18 |
| 1841523230 | Tuan Thanh Pham | Student in an Organized Health Care Education/Training Program | 393 Blossom Hill Rd, Suite 201, San Jose, CA 95123-1652 | 2009-09-16 |
| 1992956650 | Mike M Chen | Dentist | 393 Blossom Hill Rd, Ste 150, San Jose, CA 95123-1652 | 2008-09-30 |
| 1437326378 | Terrence Raymond Dwyre | Family Medicine | 393 Blossom Hill Rd, Suite 210, San Jose, CA 95123-1652 | 2008-05-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700441045 | Calvin Patrick Nell | Chiropractor | 5570 Sanchez Drive, Ste 100, San Jose, CA 95123 | 2019-05-02 |
| 1629557152 | Jia Tian | Dentist | 393 Blossom Hill Rd Ste 150, San Jose, CA 95123 | 2018-08-06 |
| 1003306176 | Western Dental Services, Inc. | Dentist | 451 Blossom Hill Rd Suite 20, San Jose, CA 95123 | 2018-05-15 |
| 1871004945 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 5411 Thornwood Dr, San Jose, CA 95123 | 2017-10-17 |
| 1437672953 | Mie Mie Chiu | Dietitian, Registered | 276 Palm Valley Blvd #205, San Jose, CA 95123 | 2017-07-18 |
| 1902335300 | Alfredo Fernandez | Counselor | 5898 Paddon Circle, San Jose, CA 95123 | 2017-06-08 |
| 1780115444 | Christopher Vi Tran | Case Manager/Care Coordinator | 5579 Lean Avenue, San Jose, CA 95123 | 2017-03-24 |
| 1205370004 | Linxi Wu | Acupuncturist | 6064 Cahalan Ave, San Jose, CA 95123 | 2016-12-13 |
| 1013307651 | Kevin Dizon | Dental Hygienist | 6071 Sunstone Drive, San Jose, CA 95123 | 2015-02-04 |
| 1285031294 | Katie Tran | Dental Assistant | 524 Glenburry Way, San Jose, CA 95123 | 2014-11-20 |
| Find all providers in zip 95123 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871004945 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 5411 Thornwood Dr, San Jose, CA 95123 | 2017-10-17 |
| 1073032249 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 2210 Tully Rd, San Jose, CA 95122-1347 | 2017-09-19 |
| 1407373509 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 334 Santana Row Ste 1005, San Jose, CA 95128-2029 | 2017-08-29 |
| 1356677116 | Peter J Montana | Eyewear Supplier (Equipment, not the service) | 1421 Courtyard Dr, San Jose, CA 95118-1936 | 2009-10-28 |
| 1780836908 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 1620 Saratoga Ave Ste P301, San Jose, CA 95129-5113 | 2008-10-21 |
| 1801935457 | For Eyes Optical of California | Eyewear Supplier (Equipment, not the service) | 1020 El Paseo De Saratoga, San Jose, CA 95130-1630 | 2007-02-06 |
| 1942353859 | Luxottica Retail North America, Inc | Eyewear Supplier (Equipment, not the service) | 2200 Eastridge Mall, Ste #1078, San Jose, CA 95122 | 2007-01-22 |
| 1174688188 | Pearle Visioncare, Inc | Eyewear Supplier (Equipment, not the service) | 1620 Saratoga Ave, Westgate S/c #p-301, San Jose, CA 95129-5113 | 2006-12-27 |
| 1750302741 | Usv Optical Inc | Eyewear Supplier (Equipment, not the service) | 2230 Eastridge Loop, San Jose, CA 95122-1465 | 2006-07-22 |
| 1215955141 | Kelly Lao Od Apc | Eyewear Supplier (Equipment, not the service) | 240 Meridian Ave, Ste 1, San Jose, CA 95126 | 2006-07-18 |
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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.