Healthcare Provider Details

I. General information

NPI: 1336267038
Provider Name (Legal Business Name): VISUALEYES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 BROADWAY ST
EUREKA CA
95501-0129
US

IV. Provider business mailing address

1209 BROADWAY ST
EUREKA CA
95501-0129
US

V. Phone/Fax

Practice location:
  • Phone: 707-442-2922
  • Fax: 707-442-7206
Mailing address:
  • Phone: 707-442-2922
  • Fax: 707-442-7206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1100X
TaxonomyOphthalmic Technician/Technologist
License NumberSL4921
License Number StateCA

VIII. Authorized Official

Name: MR. KEVIN MICHAEL CAMBRA
Title or Position: PRESIDENT
Credential: RSLD
Phone: 510-301-8317