PACIFIC VISION MEDICAL CENTER (NPI# 1346399433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346399433 |
| Entity Type | Organization |
| Organization Name | PACIFIC VISION MEDICAL CENTER |
| Practice Address |
515 E Washington Blvd Crescent City CA 95531-8342 |
| Practice Telephone | 7074652020 |
| Practice Fax Number | 7074656252 |
| Mailing Telephone | 7074652020 |
| Mailing Fax Number | 7074656252 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-06-29 |
| Authorized Official Name | LARRY A ENINGER (PARTNER) |
| Authorized Official Telephone | 7074652020 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332H00000X | Eyewear Supplier (Equipment, not the service) | 0534820001 | CA | Suppliers |
| N | 152W00000X | Optometrist | ZZZ28910Z | CA | Eye and Vision Services Providers |
| Y | 207W00000X | Ophthalmology | ZZZ28910Z | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0052190 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750423992 | Pacific Vision Medical Center | Eyewear Supplier (Equipment, not the service) | 580 5th St, Suite 500, Brookings, OR 97415-8329 | 2007-02-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PACIFIC VISION MEDICAL CENTER | 580 5th St Ste 500, Brookings, OR 97415 |
| Street Address |
515 E WASHINGTON BLVD |
| City | CRESCENT CITY |
| State | CA |
| Zip Code | 95531-8342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972588168 | Larry Allen Eninger | Ophthalmology | 515 E Washington Blvd, Crescent City, CA 95531-8342 | 2005-12-09 |
| 1518942283 | David Edmund Cink | Specialist | 515 E Washington Blvd, Crescent City, CA 95531-8342 | 2005-12-14 |
| 1497730691 | Karl Arthur Bruhns | Optometrist | 515 E Washington Blvd, Crescent City, CA 95531-8342 | 2005-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548725237 | John Michael Horner | Counselor | 455 Kst, Crescent City, CA 95531 | 2019-02-06 |
| 1245716943 | Tonya Shantel Escobar | Registered Nurse | 1301b Northcrest Drive #13, Crescent City, CA 95531 | 2018-07-16 |
| 1679019319 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 657 Hwy 101 N, Crescent City, CA 95531 | 2017-01-18 |
| 1063969558 | Darrick Stewart Roach | Massage Therapist | 1225 Marshall St., 18, Crescent City, CA 95531 | 2016-09-01 |
| 1447638044 | Yelena Zaitseva Lavender | Counselor | 455 K Street, Crescent City, CA 95531 | 2015-05-14 |
| 1942630421 | Kamilia Ann Schnacker | Counselor | 370 9th Street, Crescent City, CA 95531 | 2013-11-19 |
| 1881906261 | Peter Allen Brown | Psychologist | 505 H Street, Crescent City, CA 95531 | 2010-07-13 |
| 1700119385 | Remi Vista Services for Probation Youth | Community/Behavioral Health | 206 Williams Dr # 2, Crescent City, CA 95531 | 2009-09-14 |
| 1982862538 | Joshua Thomas Matson | Chiropractor | 550 E Washington Blvd Ste 100, Crescent City, CA 95531 | 2008-05-30 |
| 1902076250 | County of Del Norte | Community/Behavioral Health | 1125 Burtschell, Crescent City, CA 95531 | 2008-03-03 |
| Find all providers in zip 95531 | ||||
| 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 |
|---|---|---|---|---|
| 1972588168 | Larry Allen Eninger | Ophthalmology | 515 E Washington Blvd, Crescent City, CA 95531-8342 | 2005-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831790922 | Paul B Kouyoumjian, Md Inc. | Ophthalmology | 18040 Sherman Way Ste 205, Reseda, CA 91335-4631 | 2020-11-04 |
| 1700496320 | William Thomas Parker | Ophthalmology | 5279 Gaylord Pl, San Diego, CA 92117-1034 | 2020-08-07 |
| 1588274724 | Katerina Kurteeva Md Inc | Ophthalmology | 3140 Bear St Ste 100, Costa Mesa, CA 92626-2964 | 2020-08-03 |
| 1285252502 | Eyecare Specialists Medical Group, Inc | Ophthalmology | 58-471 29 Palms Hwy, Yucca Valley, CA 92284-5818 | 2020-07-13 |
| 1407473754 | Janet K. Kim Md, Inc | Ophthalmology | 903 Crenshaw Blvd Ste 105, Los Angeles, CA 90019-1972 | 2020-07-02 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | CRESCENT CITY |
| Zip Code | 95531 |
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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.