Kings Eye Center Medical Group, Inc. | |
1395 W Lacey Blvd, Hanford, CA 93230-5904 | |
(559) 585-3937 | |
(559) 582-3645 |
Full Name | Kings Eye Center Medical Group, Inc. |
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Type | Facility |
Speciality | Ophthalmology |
Location | 1395 W Lacey Blvd, Hanford, California |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1730168931 | NPI | - | NPPES |
GR0091100 | Medicaid | CA | |
GSD004060 | Medicaid | CA | |
490005146 | Other | CA | RR MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Provider Name | Stacy R Omon |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1821013707 PECOS PAC ID: 9830197748 Enrollment ID: I20061130000490 |
Provider Name | Bradley A Beard |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1821077165 PECOS PAC ID: 1951489061 Enrollment ID: I20080605000496 |
Provider Name | Ronald S Keck |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1104812346 PECOS PAC ID: 1850461666 Enrollment ID: I20080605000650 |
Provider Name | Tracey H Nguyen |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1467882480 PECOS PAC ID: 1951602580 Enrollment ID: I20151223001371 |
Provider Name | Nathan Panttaja |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1922643584 PECOS PAC ID: 0244664571 Enrollment ID: I20191219002230 |
Mailing Address | Practice Location Address |
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Kings Eye Center Medical Group, Inc. 1395 W Lacey Blvd, Hanford, CA 93230-5904 Ph: (559) 585-3937 | Kings Eye Center Medical Group, Inc. 1395 W Lacey Blvd, Hanford, CA 93230-5904 Ph: (559) 585-3937 |