Provider Demographics
NPI:1194743054
Name:BLIND & VISUALLY IMPAIRED CENTER OF MONTEREY COUNTY INC
Entity type:Organization
Organization Name:BLIND & VISUALLY IMPAIRED CENTER OF MONTEREY COUNTY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:PADIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-649-3505
Mailing Address - Street 1:225 LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-3651
Mailing Address - Country:US
Mailing Address - Phone:831-649-3505
Mailing Address - Fax:831-649-4057
Practice Address - Street 1:225 LAUREL AVE
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-3651
Practice Address - Country:US
Practice Address - Phone:831-649-3505
Practice Address - Fax:831-649-4057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9928152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACMM70396FMedicaid
CASD0099280OtherPIN
CAU70274Medicare UPIN
CACMM70396FMedicaid