Healthcare Provider Details

I. General information

NPI: 1346830031
Provider Name (Legal Business Name): CALIFORNIA OPTOMETRIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2021
Last Update Date: 02/23/2021
Certification Date: 02/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34806 YUCAIPA BLVD
YUCAIPA CA
92399-4235
US

IV. Provider business mailing address

34806 YUCAIPA BLVD
YUCAIPA CA
92399-4235
US

V. Phone/Fax

Practice location:
  • Phone: 909-797-0134
  • Fax: 909-797-0137
Mailing address:
  • Phone: 909-797-0134
  • Fax: 909-797-0137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. SAHIL ANUP DOSAJ
Title or Position: OWNER/PRESIDENT
Credential: O.D.
Phone: 909-797-0134