Healthcare Provider Details

I. General information

NPI: 1811199557
Provider Name (Legal Business Name): LOS GATOS EYES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 03/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 N SANTA CRUZ AVE
LOS GATOS CA
95030-5916
US

IV. Provider business mailing address

53 N SANTA CRUZ AVE
LOS GATOS CA
95030-5916
US

V. Phone/Fax

Practice location:
  • Phone: 408-399-8003
  • Fax: 408-399-8004
Mailing address:
  • Phone: 408-399-8003
  • Fax: 408-399-8004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ASHRAF HOSSEINI
Title or Position: PRESIDENT
Credential:
Phone: 408-624-1438