| Jack M. Elizares Optometric Corporation | |
|
3610 Old Hwy 53, Clearlake, CA 95422-9543 | |
| (707) 994-8641 | |
| (707) 994-5858 |
| Full Name | Jack M. Elizares Optometric Corporation |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 3610 Old Hwy 53, Clearlake, California |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164932976 | NPI | - | NPPES |
| SD0066460 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 6646 (California) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jack M. Elizares Optometric Corporation 3610 Old Highway 53, Clearlake, CA 95422-9253 Ph: (707) 994-8641 | Jack M. Elizares Optometric Corporation 3610 Old Hwy 53, Clearlake, CA 95422-9543 Ph: (707) 994-8641 |
Dr. Jack M Elizares, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3610 Old Highway 53, Clearlake, CA 95422 Phone: 707-994-8641 Fax: 707-994-5858 | |
Dr. Robert Bonner, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 14595 Olympic Dr, Clearlake, CA 95422 Phone: 707-994-1488 Fax: 707-994-8108 |