MEDICARE: REFINE OPTOMETRY, 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	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14365	OTHER	CA	CALIFORNIA BOARD OF OPTOMETRY

General Provider Information

NPI Number	:	1871311316
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REFINE OPTOMETRY, INC.

Provider Business Mailing Address
First Line	:	460 UNIVERSITY AVE
Second Line	:
City	:	PALO ALTO
State	:	CA
Zip	:	94301-1812
Country	:	US
Telephone Number	:	650-327-2020
Fax Number	:	650-327-2039

Provider Business Practice Location Address
First Line	:	460 UNIVERSITY AVE
Second Line	:
City	:	PALO ALTO
State	:	CA
Zip	:	94301-1812
Country	:	US
Telephone Number	:	650-327-2020
Fax Number	:	650-327-2039

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	JOY LAM
Credential	:	OD
Telephone Number	:	650-327-2020

Provider Enumeration Date	:	10/02/2024
Last Update Date	:	10/02/2024

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Directions to “REFINE OPTOMETRY, INC. ” Practice Location

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