| NPI | 1124290721 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2008-03-24 |
| Last Updated | 2016-08-25 |
| Authorized Official | Frederick Stellhorn Optometrist Phone: 2098233151 |
| Mailing Address | 140 N Fremont St Ste A Manteca, CA 95336-4729 United States Phone: (209) 823-3151 | Fax: (209) 823-9712 📍 View Map |
| Primary Practice Address | 140 N Fremont St Ste A Manteca, CA 95336-4729 United States Phone: (209) 823-3151 | Fax: (209) 823-9712 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | CA | sd0052150 | — |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 152WC0802X – Optometrist, Corneal and Contact Management | CA | 5215 TPL |
| No | 152WL0500X – Optometrist, Low Vision Rehabilitation | CA | 5215 TPL |
| No | 152WP0200X – Optometrist, Pediatrics | CA | 5215 TPL |
| No | 152WS0006X – Optometrist, Sports Vision | CA | 5215 TPL |
| No | 152WV0400X – Optometrist, Vision Therapy | CA | 5215 TPL |
| No | 152WX0102X – Optometrist, Occupational Vision | CA | 5215 TPL |
| Yes | 152W00000X – Optometrist | CA | 5215 TPL |
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About NPI 1124290721
Fred Wm Stellhorn Optometric Corporation is an organization registered in the CMS NPPES NPI Registry with NPI number 1124290721. The primary specialty listed is Optometrist. The organization is located in Manteca, CA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2008-03-24. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1124290721?
NPI 1124290721 belongs to Fred Wm Stellhorn Optometric Corporation, a Optometrist in Manteca, CA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1124290721 active?
The current status of NPI 1124290721 in the NPPES registry is Active. The record was last updated on 2016-08-25.
What specialty is NPI 1124290721?
NPI 1124290721 is classified under the taxonomy Optometrist. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1124290721?
You can verify NPI 1124290721 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1124290721?
The primary practice address on file for NPI 1124290721 is 140 N Fremont St Ste A, Manteca, CA 95336-4729. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1124290721 issued?
NPI 1124290721 was first issued (enumerated) on 2008-03-24. The NPPES record was last updated on 2016-08-25.
Practice Location Map
Fred Wm Stellhorn Optometric Corporation is located at 140 N Fremont St Ste A, Manteca, CA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Fred Wm Stellhorn Optometric Corporation. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1124290721. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Optometrist, Corneal and Contact Management | 5215 TPL | CA |
| Optometrist, Low Vision Rehabilitation | 5215 TPL | CA |
| Optometrist, Pediatrics | 5215 TPL | CA |
| Optometrist, Sports Vision | 5215 TPL | CA |
| Optometrist, Vision Therapy | 5215 TPL | CA |
| Optometrist, Occupational Vision | 5215 TPL | CA |
| Optometrist | 5215 TPL | CA |