Healthcare Provider Details
I. General information
NPI: 1376282707
Provider Name (Legal Business Name): AMERICAN LEARNING AND VISION ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/02/2022
Last Update Date: 06/02/2022
Certification Date: 06/02/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1345 S DIAMOND BAR BLVD SUITE C
DIAMOND BAR CA
91765
US
IV. Provider business mailing address
1345 S DIAMOND BAR BLVD SUITE C
DIAMOND BAR CA
91765
US
V. Phone/Fax
- Phone: 909-653-1888
- Fax:
- Phone: 909-653-1888
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WC0802X |
| Taxonomy | Corneal and Contact Management Optometrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WP0200X |
| Taxonomy | Pediatric Optometrist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WS0006X |
| Taxonomy | Sports Vision Optometrist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WV0400X |
| Taxonomy | Vision Therapy Optometrist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WX0102X |
| Taxonomy | Occupational Vision Optometrist |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YUE
ZHOU
Title or Position: OWNER
Credential: OD
Phone: 626-698-5336