Healthcare Provider Details

I. General information

NPI: 1285784595
Provider Name (Legal Business Name): COLE VISION CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3610 PECK RD
EL MONTE CA
91731-3529
US

IV. Provider business mailing address

3610 PECK RD
EL MONTE CA
91731-3529
US

V. Phone/Fax

Practice location:
  • Phone: 626-444-5642
  • Fax: 626-444-5746
Mailing address:
  • Phone: 626-444-5642
  • Fax: 626-444-5746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MS. WENDY UHLS
Title or Position: MEDICARE SUPERVISOR
Credential:
Phone: 513-765-3534