Healthcare Provider Details
I. General information
NPI: 1700065034
Provider Name (Legal Business Name): FIRSTSIGHT VISION SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/02/2007
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
705 COLLEGE BLVD
OCEANSIDE CA
92057-6259
US
IV. Provider business mailing address
1202 MONTE VISTA AVE STE 17
UPLAND CA
91786-8216
US
V. Phone/Fax
- Phone: 760-631-2877
- Fax: 760-631-2879
- Phone: 909-920-5008
- Fax: 888-241-9266
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JOSEPH
HEIDELMAN
Title or Position: CFO
Credential:
Phone: 909-920-5008