Healthcare Provider Details

I. General information

NPI: 1932011707
Provider Name (Legal Business Name): SHEPHERDS VIEW OPTICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 E HUFF ST
RIALTO CA
92376-7198
US

IV. Provider business mailing address

625 E HUFF ST
RIALTO CA
92376-7198
US

V. Phone/Fax

Practice location:
  • Phone: 909-554-0900
  • Fax:
Mailing address:
  • Phone: 909-554-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name: MR. ALEX RAMIREZ
Title or Position: OPTICIAN
Credential: ABO
Phone: 909-554-0900