Healthcare Provider Details

I. General information

NPI: 1003722844
Provider Name (Legal Business Name): BRIAN VO OPTOMETRIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8137 MIRA MESA BLVD
SAN DIEGO CA
92126-2601
US

IV. Provider business mailing address

10667 GOLDEN WILLOW UNIT 152
SAN DIEGO CA
92130-4950
US

V. Phone/Fax

Practice location:
  • Phone: 858-879-3480
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRIAN VO
Title or Position: OPTOMETRIST/PRESIDENT
Credential: OD
Phone: 817-791-4654