Pediatric Ophthalmology is a
Ophthalmology based in Salt Lake City, Utah. Pediatric Ophthalmology is licensed to practice in * (Not Available) (license number ) and their current practice location is
100 N Mario Capecchi Dr, Salt Lake City, Utah. It can be reached at their office (for appointments etc.) via phone at
(801) 587-6336.
NPI number for Pediatric Ophthalmology is 1740644301 and their current mailing address is Po Box 841450, Los Angeles, California. Pediatric Ophthalmology
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1740644301.
Healthcare Provider's Profile
| Full Name | Pediatric Ophthalmology |
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| Type | Facility |
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| Speciality | Ophthalmology |
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| Location | 100 N Mario Capecchi Dr, Salt Lake City, Utah |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1740644301
- Provider Enumeration Date: 04/11/2016
- Last Update Date: 01/22/2021
Medical Identifiers
Medical identifiers for Pediatric Ophthalmology such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1740644301 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152WP0200X | Optometrist - Pediatrics | (* (Not Available)) | Secondary |
| 156FC0800X | Technician/technologist - Contact Lens | (* (Not Available)) | Secondary |
| 156FC0801X | Technician/technologist - Contact Lens Fitter | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Pediatric Ophthalmology is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Pediatric Ophthalmology
Po Box 841450,
Los Angeles, CA 90084-1450
Ph: (801) 213-3900 | Pediatric Ophthalmology
100 N Mario Capecchi Dr,
Salt Lake City, UT 84113-1103
Ph: (801) 587-6336 |
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