| |
7350 Madison Ave, Fair Oaks, CA 95628-3309 | |
(916) 863-1534 | |
(561) 828-8367 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 7350 Madison Ave, Fair Oaks, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1114218997 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 11554 (California) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
3081 S. Congress Avenue, Palm Springs, FL 33461 Ph: (561) 275-2020 | 7350 Madison Ave, Fair Oaks, CA 95628-3309 Ph: (916) 863-1534 |