Healthcare Provider Details

I. General information

NPI: 1174396568
Provider Name (Legal Business Name): GALT FAMILY OPTOMETRIC CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2023
Last Update Date: 03/04/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 SPAANS DR STE A
GALT CA
95632-8611
US

IV. Provider business mailing address

730 SPAANS DR STE A
GALT CA
95632-8611
US

V. Phone/Fax

Practice location:
  • Phone: 209-745-2880
  • Fax: 209-745-6840
Mailing address:
  • Phone: 209-745-2880
  • Fax: 209-745-6840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLEE ITSUKO SAKAI
Title or Position: OWNER
Credential:
Phone: 209-745-2880