| Innovative Eye Care Optometric Corporation | |
|
4903 Calloway Dr Ste 101 Bakersfield CA 93312-9711 | |
| (661) 213-3310 | |
| (661) 213-3315 |
| Full Name | Innovative Eye Care Optometric Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 4903 Calloway Dr Ste 101, Bakersfield, California |
| Authorized Official Name and Position | Cheree A Wilhelmsen (PRESIDENT) |
| Authorized Official Contact | 6612133310 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Eye Care Optometric Corporation 4903 Calloway Dr Ste 101 Bakersfield CA 93312-9711 Ph: (661) 213-3310 | Innovative Eye Care Optometric Corporation 4903 Calloway Dr Ste 101 Bakersfield CA 93312-9711 Ph: (661) 213-3310 |
| NPI Number | 1881947794 |
|---|---|
| Provider Enumeration Date | 10/17/2012 |
| Last Update Date | 08/03/2022 |
| Medicare PECOS PAC ID | 6204081193 |
|---|---|
| Medicare Enrollment ID | O20130226000319 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881947794 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 10443T (California) | Primary |
| Provider Name | Cheree Wilhelmsen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1659489102 PECOS PAC ID: 1759536659 Enrollment ID: I20130226000427 |
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