Healthcare Provider Details

I. General information

NPI: 1508259839
Provider Name (Legal Business Name): VISION TO LEARN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2015
Last Update Date: 11/10/2021
Certification Date: 11/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12100 WILSHIRE BLVD STE 1275
LOS ANGELES CA
90025-7143
US

IV. Provider business mailing address

12100 WILSHIRE BLVD STE 1275
LOS ANGELES CA
90025-7143
US

V. Phone/Fax

Practice location:
  • Phone: 302-563-4740
  • Fax: 213-402-5261
Mailing address:
  • Phone: 800-485-9196
  • Fax: 213-402-5261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANN HOLLISTER
Title or Position: PRESIDENT
Credential:
Phone: 800-485-9196