MEDICARE: PACVISION INCORPORATED

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	152W00000X	Optometrist	CA11224	CA

General Provider Information

NPI Number	:	1760865604
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACVISION INCORPORATED

Provider Business Mailing Address
First Line	:	6930 65TH ST
Second Line	:	SUITE # 113
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-2343
Country	:	US
Telephone Number	:	916-395-7571
Fax Number	:	916-395-7195

Provider Business Practice Location Address
First Line	:	6930 65TH ST
Second Line	:	SUITE # 113
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-2343
Country	:	US
Telephone Number	:	916-395-7571
Fax Number	:	916-395-7195

Authorized Official
Title or Position	:	CEO
Name	:	DR. SANG HUU TRAN
Credential	:	OD
Telephone Number	:	916-395-7571

Provider Enumeration Date	:	07/09/2015
Last Update Date	:	01/13/2016

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Directions to “PACVISION INCORPORATED ” Practice Location

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