Provider Demographics
NPI:1427139377
Name:VISALIA EYE CENTER, INC.
Entity type:Organization
Organization Name:VISALIA EYE CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:FEIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-733-4372
Mailing Address - Street 1:112 N AKERS ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-5121
Mailing Address - Country:US
Mailing Address - Phone:559-733-4372
Mailing Address - Fax:559-733-1758
Practice Address - Street 1:112 N AKERS ST
Practice Address - Street 2:SUITE A
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5121
Practice Address - Country:US
Practice Address - Phone:559-733-4372
Practice Address - Fax:559-733-1758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT8061152W00000X
CAOPT12847 TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA14179553498OtherMICHAEL BAUMANN NPI#
CAOPT8061OtherMICHAEL BAUMANN, OD LIC#
CASD0128470Medicaid
CA1366472938OtherMATTHEW OBLAD NPI#
CAGSD005170Medicaid
CAOPT12847 TPAOtherMATTHEW OBLAD, OD LIC#
CASD0080612Medicaid
CASD0080612Medicaid
CAOPT8061OtherMICHAEL BAUMANN, OD LIC#