Kenneth Bracken, OD | |
1356 E Main St Ste A, Barstow, CA 92311-3241 | |
(760) 256-8014 | |
Not Available |
Full Name | Kenneth Bracken |
---|---|
Gender | Male |
Speciality | Optometrist |
Location | 1356 E Main St Ste A, Barstow, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1356652622 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 13954 (California) | Primary |
Provider Name | Southern California Permanente Medical Group |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823 |
Provider Name | James R. Dallas, O.d. |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1407885585 PECOS PAC ID: 9830135367 Enrollment ID: O20050706000439 |
Mailing Address | Practice Location Address |
---|---|
Kenneth Bracken, OD 1356 E Main St Ste A, Barstow, CA 92311-3241 Ph: (760) 256-8014 | Kenneth Bracken, OD 1356 E Main St Ste A, Barstow, CA 92311-3241 Ph: (760) 256-8014 |
Richard Kennedy, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 945 Armory Rd Ste C, Barstow, CA 92311 Phone: 760-252-7518 Fax: 760-252-7510 | |
James Ronald Dallas, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1356 -- A East Main St., Barstow, CA 92311 Phone: 760-256-8014 | |
James R. Dallas, O.d. Optometrist Medicare: Medicare Enrolled Practice Location: 1356 E Main St, #a, Barstow, CA 92311 Phone: 760-256-8014 | |
Cya Optometry Corporation Optometrist Medicare: Medicare Enrolled Practice Location: 945 Armory Rd Ste C, Barstow, CA 92311 Phone: 760-252-7518 Fax: 760-252-7510 | |
Michael David Allen, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1356 E Main St Ste A, Barstow, CA 92311 Phone: 760-256-8014 Fax: 760-256-8568 | |
Jason Michael Drobeck, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1356 A. East Main St., Barstow, CA 92311 Phone: 760-256-8014 Fax: 760-256-8568 |