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General NPI Number Information
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NPI Number | 1134795974
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Entity Type | Organization
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Legal Business Name | SITE FOR SIGHT OPTOMETRY, INC.
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Dates
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Enumeration Date | 06/02/2021
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Last Update Date | 08/22/2023
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Provider Practice Location Address
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Address Line | 215 ALAMO PLZ STE D
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City | ALAMO
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State | CA
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Zip | 94507-1531
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Country | US
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Telephone | 925-202-2846
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Fax | 925-648-1127
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Provider Business Mailing Address
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Address Line | PO BOX 1973
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City | DANVILLE
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State | CA
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Zip | 94526-6973
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Country | US
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Telephone |
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Fax | 925-648-1127
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Authorized Official
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Title or Position | CEO
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Name | DR. BEVERLY JUE SMITH
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Credential | OD, MS, MBA
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Telephone | 925-202-2846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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