Provider Demographics
NPI:1861959280
Name:GENEVIEVE KIM CORRIGAN OD INC
Entity type:Organization
Organization Name:GENEVIEVE KIM CORRIGAN OD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:GENEVIEVE
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:CORRIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:916-933-5535
Mailing Address - Street 1:2209 FRANCISCO DR STE 150
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-3805
Mailing Address - Country:US
Mailing Address - Phone:916-933-5535
Mailing Address - Fax:916-933-9168
Practice Address - Street 1:2209 FRANCISCO DR STE 150
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-3805
Practice Address - Country:US
Practice Address - Phone:916-933-5335
Practice Address - Fax:916-933-9168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-21
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty