MEDICARE: SAVADA-ADAMICH OPTICIANS INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ75185Z	OTHER	CA	EYEGLASSES

General Provider Information

NPI Number	:	1205991429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAVADA-ADAMICH OPTICIANS INC.

Provider Business Mailing Address
First Line	:	2666 BROADWAY ST
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94063-1533
Country	:	US
Telephone Number	:	650-364-3883
Fax Number	:	650-364-3873

Provider Business Practice Location Address
First Line	:	2666 BROADWAY ST
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94063-1533
Country	:	US
Telephone Number	:	650-364-3883
Fax Number	:	650-364-3873

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROGER O SANDOVAL
Credential	:
Telephone Number	:	650-364-3883

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	08/22/2020

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