Provider Demographics
NPI:1194869651
Name:MAXIMEYES CORPORATION
Entity type:Organization
Organization Name:MAXIMEYES CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCALLISTER
Authorized Official - Suffix:
Authorized Official - Credentials:RSLD RCLD
Authorized Official - Phone:707-449-9931
Mailing Address - Street 1:2080 HARBISON DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-3908
Mailing Address - Country:US
Mailing Address - Phone:707-449-9931
Mailing Address - Fax:707-449-9330
Practice Address - Street 1:2080 HARBISON DR
Practice Address - Street 2:SUITE E
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-3908
Practice Address - Country:US
Practice Address - Phone:707-449-9931
Practice Address - Fax:707-449-9330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD6918156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty