Healthcare Provider Details
I. General information
NPI: 1114524972
Provider Name (Legal Business Name): HELLO OPTOMETRY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/05/2020
Last Update Date: 03/29/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
141 N GLASSELL ST
ORANGE CA
92866-1406
US
IV. Provider business mailing address
141 N GLASSELL ST
ORANGE CA
92866-1406
US
V. Phone/Fax
- Phone: 657-650-2020
- Fax: 657-650-2021
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WC0802X |
| Taxonomy | Corneal and Contact Management Optometrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332H00000X |
| Taxonomy | Eyewear Supplier |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EDWARD
TRAN
Title or Position: CFO
Credential: OD
Phone: 657-650-2020