Healthcare Provider Details

I. General information

NPI: 1750176533
Provider Name (Legal Business Name): EYE SEA OPTOMETRY APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2025
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 C ST
DAVIS CA
95616-4521
US

IV. Provider business mailing address

231 C ST
DAVIS CA
95616-4521
US

V. Phone/Fax

Practice location:
  • Phone: 530-758-4000
  • Fax: 530-758-4016
Mailing address:
  • Phone: 530-758-4000
  • Fax: 530-758-4016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: GAGANJOT KAUR VIRK
Title or Position: AUTHORIZED OFFICIAL/OD/OWNER
Credential: OD
Phone: 530-758-4000