| NPI | 1487601522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL WILHELM Administrator/Controller 408-252-7310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA OPT 13831 TLG) |
| 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: CA SRYGH 97-67584700006) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2016-02-02 |