Healthcare Provider Details

I. General information

NPI: 1780774596
Provider Name (Legal Business Name): THE VISION CENTER AN OPTOMETRIC PRACTICE INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 04/29/2020
Certification Date: 04/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26506 BOUQUET CANYON RD
SAUGUS CA
91350-2353
US

IV. Provider business mailing address

26506 BOUQUET CANYON RD
SAUGUS CA
91350-2353
US

V. Phone/Fax

Practice location:
  • Phone: 661-297-2020
  • Fax: 661-297-3380
Mailing address:
  • Phone: 661-297-2020
  • Fax: 661-297-3380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4873T
License Number StateCA

VIII. Authorized Official

Name: DR. LARA MIEKO UMEMOTO
Title or Position: OPTOMETRIST, OWNER, PRESIDENT
Credential: OD
Phone: 661-297-2020