| West Valley Vision Source | |
|
2782 S 5600 W Ste 101, West Valley City, UT 84120-5592 | |
| (801) 969-9999 | |
| (801) 746-1007 |
| Full Name | West Valley Vision Source |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 2782 S 5600 W Ste 101, West Valley City, Utah |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427241843 | NPI | - | NPPES |
| 7664549 | Other | AETNA | |
| 2157848 | Other | FIRST HEALTH | |
| 528558921001 | Medicaid | UT | |
| 81648 | Other | PEHP | |
| IDX5199969 | Other | UT | UNIVERSITY HEALTH CARE |
| TPRA08151 | Other | UT | MOLINA HEALTHCARE |
| 49420859901 | Other | BLUE CROSS BLUE SHIELD | |
| 291777 | Other | ALTIUS | |
| 5510561 | Other | CCN | |
| 788511 | Other | DESERET MUTUAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 4942085-9934 (Utah) | Primary |
| Provider Name | Paul C Bruderer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1316956576 PECOS PAC ID: 6507768942 Enrollment ID: I20040124000430 |
| Mailing Address | Practice Location Address |
|---|---|
| West Valley Vision Source 2782 S 5600 W Ste 101, West Valley City, UT 84120-5592 Ph: (801) 969-9999 | West Valley Vision Source 2782 S 5600 W Ste 101, West Valley City, UT 84120-5592 Ph: (801) 969-9999 |
Christopher Mark Troxel, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 3620 W 3500 S, West Valley City, UT 84120 Phone: 801-966-9975 Fax: 801-963-3900 | |
Ngoc Judy Tran, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2731 S 5600 W Ste E, West Valley City, UT 84120 Phone: 385-324-5641 | |
Mrs. Jeannette Pontiero Meandzija, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2727 W 3500 S, West Valley City, UT 84119 Phone: 801-968-6772 | |
Dr. Shawn D Beagley Optometrist Pllc Optometrist Medicare: Medicare Enrolled Practice Location: 3747 S 2700 W, West Valley City, UT 84119 Phone: 801-996-9021 | |
Mountain West Eyecare Inc Optometrist Medicare: Medicare Enrolled Practice Location: 2727 W 3500 S, West Valley City, UT 84119 Phone: 801-968-6772 Fax: 801-968-6771 | |
Dr. Bryan O'dell Frandsen, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3029 S Colt Plaza Dr, West Valley City, UT 84128 Phone: 801-968-6772 | |
Bethany Ruth Gillett, OD Optometrist Medicare: Medicare Enrolled Practice Location: 3029 S Colt Plaza Dr Ste 1, West Valley City, UT 84128 Phone: 801-968-6772 Fax: 801-968-6771 |