SISKIYOU EYE CENTER, MEDICAL GROUP, INC (NPI# 1144224577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144224577 |
| Entity Type | Organization |
| Organization Name | SISKIYOU EYE CENTER, MEDICAL GROUP, INC |
| Other Organization Name | SISKIYOU EYE CENTER |
| Practice Address |
2524 Westside Rd Yreka CA 96097-9129 |
| Practice Telephone | 5308422760 |
| Practice Fax Number | 5308425839 |
| Mailing Telephone | 5308422760 |
| Mailing Fax Number | 5308425839 |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2010-03-11 |
| Authorized Official Name | MS. BELMIRA PARDAL BORG (ADMINISTRATOR) |
| Authorized Official Telephone | 5308422760 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | FNP26049 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BXBS OF CA | ZZZ550452 | 01 |
| Other Name | Type Code |
|---|---|
| Siskiyou Eye Center | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SISKIYOU EYE CENTER, MEDICAL GROUP, INC. | 648 N Main St, Ashland, OR 97520 |
| Street Address |
2524 WESTSIDE RD |
| City | YREKA |
| State | CA |
| Zip Code | 96097-9129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407895964 | Jason Mark Larsen | Optometrist | 2524 Westside Rd, Yreka, CA 96097-9129 | 2006-06-06 |
| 1295730927 | Irvin Jack Cowley | Ophthalmology | 2524 Westside Rd, Yreka, CA 96097-9129 | 2005-06-17 |
| 1922003821 | Siskiyou Optical | Ophthalmology | 2524 Westside Rd, Yreka, CA 96097-9129 | 2005-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376830653 | Paul William Willis | Pharmacist | 807 S. Main St., Yreka, CA 96097 | 2011-07-07 |
| 1578883864 | Ginger A Bert | Chiropractor | 106 Ranch Ln Ste A, Yreka, CA 96097 | 2010-06-09 |
| 1669796611 | Rebekah Joyce Retterath | Dietitian, Registered | 444 Bruce Street, Yreka, CA 96097 | 2010-03-19 |
| 1780849679 | Donna Jean May | Marriage & Family Therapist | 625 Butte Street, Yreka, CA 96097 | 2008-07-21 |
| 1114121589 | Loren Cronk | Marriage & Family Therapist | 208 4th Street, Yreka, CA 96097 | 2007-06-12 |
| 1093928863 | Kristin Rene Kopplin | Psychologist | 1515 South Oregon Street, Suite A, Yreka, CA 96097 | 2007-05-08 |
| 1073735379 | Rivkah Lynn Barmore | Social Worker | 1515 S Oregon, Suite A, Yreka, CA 96097 | 2007-05-03 |
| 1649492091 | Randy Terry Murieen | Social Worker | 1515 S Oregon Street, Suite A, Yreka, CA 96097 | 2007-05-03 |
| 1265654537 | Roy Victor Hall Jr. | Social Worker | 1515 South Oregon St, Suite A, Yreka, CA 96097 | 2007-05-03 |
| 1578785614 | Meadowlark | Assisted Living Facility | 351 Bruce St, Yreka, CA 96097 | 2007-05-02 |
| Find all providers in zip 96097 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295730927 | Irvin Jack Cowley | Ophthalmology | 2524 Westside Rd, Yreka, CA 96097-9129 | 2005-06-17 |
| 1922003821 | Siskiyou Optical | Ophthalmology | 2524 Westside Rd, Yreka, CA 96097-9129 | 2005-06-16 |
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|---|---|---|---|---|
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| 1699392506 | Desert Ophthalmology Medical Corporation | Ophthalmology | 72650 Fred Waring Dr Ste 109, Palm Desert, CA 92260-5008 | 2020-06-26 |
| 1942821566 | Simon Eyes, Inc. | Ophthalmology | 3260 Beard Rd Ste 5, Napa, CA 94558-3466 | 2020-05-05 |
| 1942821905 | Nathan Abraham Md Vision Professionals Inc | Ophthalmology | 24305 Town Center Dr Ste 160, Valencia, CA 91355-1347 | 2020-04-30 |
| 1720609878 | Don Saul Ellis | Ophthalmology | 343 11th St, Del Mar, CA 92014-2607 | 2020-04-29 |
| 1245851534 | Santa Barbara Eyecare Inc., A Professional Medical Corporation | Ophthalmology | 2946 De La Vina St, Santa Barbara, CA 93105-3310 | 2020-04-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.