Healthcare Provider Details

I. General information

NPI: 1154744134
Provider Name (Legal Business Name): LOOKSIE OPTOMETRY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2014
Last Update Date: 07/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 POLK ST
SAN FRANCISCO CA
94109-4614
US

IV. Provider business mailing address

1314 POLK ST
SAN FRANCISCO CA
94109-4614
US

V. Phone/Fax

Practice location:
  • Phone: 415-593-5348
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number12659
License Number StateCA

VIII. Authorized Official

Name: AMY T TRAN
Title or Position: PRESIDENT/OWNERE
Credential: OD
Phone: 415-593-5348