Provider Demographics
NPI:1053416362
Name:ALTA VIEW EYE CARE CENTER
Entity type:Organization
Organization Name:ALTA VIEW EYE CARE CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATHEW
Authorized Official - Middle Name:R
Authorized Official - Last Name:TEMPEST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-572-0631
Mailing Address - Street 1:9720 SO. 1300 E.
Mailing Address - Street 2:STE. E210
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094
Mailing Address - Country:US
Mailing Address - Phone:801-572-0631
Mailing Address - Fax:801-572-0670
Practice Address - Street 1:9720 SO. 1300 E.
Practice Address - Street 2:STE. E210
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094
Practice Address - Country:US
Practice Address - Phone:801-572-0631
Practice Address - Fax:801-572-0670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTH38001Medicare UPIN
UT005521901Medicare ID - Type UnspecifiedDR. MATHEW R. TEMPEST