| |
5575 W. Las Positas Blvd., Suite 240, Pleasanton, CA 94588-5802 | |
(925) 460-5000 | |
(925) 460-5040 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 5575 W. Las Positas Blvd., Pleasanton, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1669471835 | NPI | - | NPPES |
00G160910 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (California) | Secondary |
207W00000X | Ophthalmology | (California) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
5575 W Las Positas Blvd, Suite 240, Pleasanton, CA 94588-5801 Ph: (925) 460-5000 | 5575 W. Las Positas Blvd., Suite 240, Pleasanton, CA 94588-5802 Ph: (925) 460-5000 |