Provider Demographics
NPI:1548978604
Name:REDDING VISION CARE OPTOMETRIC PRACTICE
Entity type:Organization
Organization Name:REDDING VISION CARE OPTOMETRIC PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DORA
Authorized Official - Middle Name:G
Authorized Official - Last Name:SZYMANOWICZ NAGY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:530-722-3533
Mailing Address - Street 1:3872 THOMASON TRL
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-9684
Mailing Address - Country:US
Mailing Address - Phone:530-722-3533
Mailing Address - Fax:
Practice Address - Street 1:4805 BECHELLI LANE
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002
Practice Address - Country:US
Practice Address - Phone:530-722-3533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty