| Sylvan Eye Associates, A Medical Corporation | |
|
1011 Sylvan Ave, Suite A, Modesto, CA 95350-1692 | |
| (209) 575-2020 | |
| (209) 758-5693 |
| Full Name | Sylvan Eye Associates, A Medical Corporation |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 1011 Sylvan Ave, Modesto, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740279207 | NPI | - | NPPES |
| GR0088410 | Other | CA | OPTHALMOLOGY MEDICAL |
| GSD088411 | Medicaid | CA | |
| ZZZ00823Z | Other | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Primary |
| Provider Name | Jeffery Adkins |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1255309696 PECOS PAC ID: 2860450814 Enrollment ID: I20041222000511 |
| Provider Name | Ronald F Janda |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003843087 PECOS PAC ID: 7113929407 Enrollment ID: I20070215000769 |
| Provider Name | Jeffrey J Ing |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1871600114 PECOS PAC ID: 8426129370 Enrollment ID: I20080619000561 |
| Provider Name | Kerry A Horner |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467441931 PECOS PAC ID: 2264518570 Enrollment ID: I20081209000210 |
| Provider Name | Stanley M Martin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1093704264 PECOS PAC ID: 8527144831 Enrollment ID: I20090121000614 |
| Provider Name | Ethan H Tittler |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1649562406 PECOS PAC ID: 6800102591 Enrollment ID: I20150825005719 |
| Provider Name | Daniel Youngjun Choi |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1801164827 PECOS PAC ID: 6901114990 Enrollment ID: I20150924000793 |
| Provider Name | Lina Lee |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1215186598 PECOS PAC ID: 6800181298 Enrollment ID: I20160824001870 |
| Provider Name | Marissa B Wall |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1265915615 PECOS PAC ID: 0143569012 Enrollment ID: I20211027003477 |
| Mailing Address | Practice Location Address |
|---|---|
| Sylvan Eye Associates, A Medical Corporation 1011 Sylvan Ave, Suite A, Modesto, CA 95350-1692 Ph: (209) 575-2020 | Sylvan Eye Associates, A Medical Corporation 1011 Sylvan Ave, Suite A, Modesto, CA 95350-1692 Ph: (209) 575-2020 |