Provider Demographics
NPI:1982940912
Name:OMNI EYE CARE, INC.
Entity type:Organization
Organization Name:OMNI EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGAI LAPSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-354-2604
Mailing Address - Street 1:554 E SAN BERNARDINO RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1747
Mailing Address - Country:US
Mailing Address - Phone:626-332-1888
Mailing Address - Fax:626-332-1808
Practice Address - Street 1:554 E SAN BERNARDINO RD
Practice Address - Street 2:SUITE 102
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1747
Practice Address - Country:US
Practice Address - Phone:626-332-1888
Practice Address - Fax:626-332-1808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-19
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60095532207R00000X
CAA114121207R00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1376555862OtherNPI