Provider Demographics
NPI:1124992060
Name:KATHERINE WITMEYER, OD, A PROFESSIONAL OPTOMETRIC CORPORATION
Entity type:Organization
Organization Name:KATHERINE WITMEYER, OD, A PROFESSIONAL OPTOMETRIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WITMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:858-381-3123
Mailing Address - Street 1:PO BOX 2644
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-2644
Mailing Address - Country:US
Mailing Address - Phone:858-381-3123
Mailing Address - Fax:858-381-3414
Practice Address - Street 1:6037 LA GRANADA
Practice Address - Street 2:SUITE F
Practice Address - City:RANCHO SANTA FE
Practice Address - State:CA
Practice Address - Zip Code:92067
Practice Address - Country:US
Practice Address - Phone:858-381-3123
Practice Address - Fax:858-381-3414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty