Healthcare Provider Details

I. General information

NPI: 1881177293
Provider Name (Legal Business Name): ISEEU OPTOMETRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2018
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44100 JEFFERSON ST STE E507
INDIO CA
92201-2715
US

IV. Provider business mailing address

44100 JEFFERSON ST STE E507
INDIO CA
92201-2715
US

V. Phone/Fax

Practice location:
  • Phone: 760-848-0040
  • Fax: 760-609-4775
Mailing address:
  • Phone: 760-848-0040
  • Fax: 760-609-4775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: VI NGUYEN
Title or Position: OWNER
Credential:
Phone: 760-848-0040