Healthcare Provider Details

I. General information

NPI: 1033173315
Provider Name (Legal Business Name): SAN DIEGO CENTER FOR VISION CARE OPTOMETRY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7898 BROADWAY
LEMON GROVE CA
91945
US

IV. Provider business mailing address

7898 BROADWAY
LEMON GROVE CA
91945
US

V. Phone/Fax

Practice location:
  • Phone: 619-464-7713
  • Fax: 619-464-7668
Mailing address:
  • Phone: 619-464-7713
  • Fax: 619-464-7668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. CARL G HILLIER
Title or Position: PRESIDENT
Credential: OD
Phone: 619-464-7713