Healthcare Provider Details
I. General information
NPI: 1871311316
Provider Name (Legal Business Name): REFINE OPTOMETRY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2024
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
460 UNIVERSITY AVE
PALO ALTO CA
94301-1812
US
IV. Provider business mailing address
460 UNIVERSITY AVE
PALO ALTO CA
94301-1812
US
V. Phone/Fax
- Phone: 650-327-2020
- Fax: 650-327-2039
- Phone: 650-327-2020
- Fax: 650-327-2039
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:
JOY
LAM
Title or Position: OPTOMETRIST
Credential: OD
Phone: 650-327-2020