DOUGLAS A LIDDICOAT INC (NPI# 1831391937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831391937 |
| Entity Type | Organization |
| Organization Name | DOUGLAS A LIDDICOAT INC |
| Practice Address |
160 Green Valley Rd Suite 202 Freedom CA 95019-3160 |
| Practice Telephone | 8317282020 |
| Practice Fax Number | 8317284739 |
| Mailing Telephone | 8317282020 |
| Mailing Fax Number | 8317284739 |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DOUGLAS A LIDDICOAT (PRESIDENT) |
| Authorized Official Telephone | 8317282020 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | C19432 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | OOC194320 | 05 |
| Street Address |
160 GREEN VALLEY RD SUITE 202 |
| City | FREEDOM |
| State | CA |
| Zip Code | 95019-3160 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790799047 | Watsonville Surgeons Group LLC | Clinic/Center | 160 Green Valley Rd, Suite 101, Freedom, CA 95019-3160 | 2006-07-29 |
| 1154969806 | Stacey C Hanlon Md PC | Anesthesiology | 160 Green Valley Rd, Freedom, CA 95019-3160 | 2019-12-12 |
| 1871849984 | Anne Morganti Kato | Ophthalmology | 160 Green Valley Rd, #202, Freedom, CA 95019-3160 | 2012-07-26 |
| 1033342829 | John V. Crowder Jr M.d. Inc. | Ophthalmology | 160 Green Valley Rd, Suite202, Freedom, CA 95019-3160 | 2009-08-27 |
| 1013150085 | William C Kadell | Optometrist | 160 Green Valley Rd, Suite 202, Freedom, CA 95019-3160 | 2009-04-07 |
| 1104095058 | Conrad Hamako, M.d. Inc. | Ophthalmology | 160 Green Valley Rd, Suite 202, Freedom, CA 95019-3160 | 2008-02-25 |
| 1841469798 | John V Crowder Jr Md Inc | Ophthalmology | 160 Green Valley Rd, Suite 202, Freedom, CA 95019-3160 | 2008-02-25 |
| 1558565416 | Thomas M Leverone M D Inc | Anesthesiology | 160 Green Valley Rd, Freedom, CA 95019-3160 | 2007-06-13 |
| 1164560066 | Coastal Eye Associates, A Medical Corporation | Ophthalmology | 160 Green Valley Rd, Suite 202, Freedom, CA 95019-3160 | 2007-02-02 |
| 1669551271 | Green Valley Laser, LLC | Durable Medical Equipment & Medical Supplies | 160 Green Valley Rd, Suite 201, Freedom, CA 95019-3160 | 2006-11-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649757428 | J. B. Physical Therapy, Inc. | Physical Therapist | 212 Green Valley Road, Freedom, CA 95019 | 2018-07-24 |
| 1639514441 | Isamar Baeza | Counselor | 2716 Freedom Blvd., Freedom, CA 95019 | 2013-05-07 |
| 1174891386 | Lisa Patrice Hamil | Pharmacist | 1810 Freedom Blvd., Freedom, CA 95019 | 2011-12-02 |
| 1346363710 | Chad Truong | Dentist | 2016 Freedom Boulevard, Freedom, CA 95019 | 2007-04-09 |
| 1962539585 | Frederick Wen Kang Chen | Internal Medicine | 243 Green Valley Rd Suite #e, Freedom, CA 95019 | 2007-02-28 |
| 1538277819 | Jacqueline Morris-lopez | Physician Assistant | 108 Green Valley Rd, Freedom, CA 95019 | 2006-08-28 |
| 1912979725 | Angela Molina | Anesthesiology | 160 Green Valley Rd Ste 101, Freedom, CA 95019 | 2006-02-06 |
| 1194704973 | David A South Md & Kim M Albridge Md A Medical Corporation | Dermatology | 204 Green Valley Road, Freedom, CA 95019 | 2006-01-11 |
| 1699232108 | Kayhan Mashouf Dmd Inc | Dentist | 270 Green Valley Rd, Freedom, CA 95019 | 2019-02-21 |
| 1194215434 | Hai Phu Duong | Pharmacist | 1810 Freedom Blvd, Freedom, CA 95019 | 2018-05-11 |
| Find all providers in zip 95019 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679675029 | Conrad Hamako | Ophthalmology | 160 Green Valley Road, Suite 202, Freedom, CA 95019-3160 | 2006-09-05 |
| 1871849984 | Anne Morganti Kato | Ophthalmology | 160 Green Valley Rd, #202, Freedom, CA 95019-3160 | 2012-07-26 |
| 1033342829 | John V. Crowder Jr M.d. Inc. | Ophthalmology | 160 Green Valley Rd, Suite202, Freedom, CA 95019-3160 | 2009-08-27 |
| 1104095058 | Conrad Hamako, M.d. Inc. | Ophthalmology | 160 Green Valley Rd, Suite 202, Freedom, CA 95019-3160 | 2008-02-25 |
| 1841469798 | John V Crowder Jr Md Inc | Ophthalmology | 160 Green Valley Rd, Suite 202, Freedom, CA 95019-3160 | 2008-02-25 |
| 1164560066 | Coastal Eye Associates, A Medical Corporation | Ophthalmology | 160 Green Valley Rd, Suite 202, Freedom, CA 95019-3160 | 2007-02-02 |
| 1558450932 | Lawrence A Birndorf | Ophthalmology | 160 Green Valley Rd, Suite 202, Freedom, CA 95019-3160 | 2006-10-12 |
| 1215021480 | John V Crowder Jr. | Ophthalmology | 160 Green Valley Rd, Suite 202, Freedom, CA 95019-3160 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831790922 | Paul B Kouyoumjian, Md Inc. | Ophthalmology | 18040 Sherman Way Ste 205, Reseda, CA 91335-4631 | 2020-11-04 |
| 1700496320 | William Thomas Parker | Ophthalmology | 5279 Gaylord Pl, San Diego, CA 92117-1034 | 2020-08-07 |
| 1588274724 | Katerina Kurteeva Md Inc | Ophthalmology | 3140 Bear St Ste 100, Costa Mesa, CA 92626-2964 | 2020-08-03 |
| 1285252502 | Eyecare Specialists Medical Group, Inc | Ophthalmology | 58-471 29 Palms Hwy, Yucca Valley, CA 92284-5818 | 2020-07-13 |
| 1407473754 | Janet K. Kim Md, Inc | Ophthalmology | 903 Crenshaw Blvd Ste 105, Los Angeles, CA 90019-1972 | 2020-07-02 |
| 1699392506 | Desert Ophthalmology Medical Corporation | Ophthalmology | 72650 Fred Waring Dr Ste 109, Palm Desert, CA 92260-5008 | 2020-06-26 |
| 1942821566 | Simon Eyes, Inc. | Ophthalmology | 3260 Beard Rd Ste 5, Napa, CA 94558-3466 | 2020-05-05 |
| 1942821905 | Nathan Abraham Md Vision Professionals Inc | Ophthalmology | 24305 Town Center Dr Ste 160, Valencia, CA 91355-1347 | 2020-04-30 |
| 1720609878 | Don Saul Ellis | Ophthalmology | 343 11th St, Del Mar, CA 92014-2607 | 2020-04-29 |
| 1245851534 | Santa Barbara Eyecare Inc., A Professional Medical Corporation | Ophthalmology | 2946 De La Vina St, Santa Barbara, CA 93105-3310 | 2020-04-28 |
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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.