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General NPI Number Information
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NPI Number | 1174061139
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Entity Type | Organization
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Legal Business Name | CLEAR SIGHT OPTOMETRY TEMECULA EYE CARE, INC.
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Dates
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Enumeration Date | 02/09/2017
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Last Update Date | 02/09/2017
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Provider Practice Location Address
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Address Line | 27540 YNEZ RD STE J15
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City | TEMECULA
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State | CA
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Zip | 92591-4604
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Country | US
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Telephone | 951-506-0021
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Fax | 951-506-0022
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Provider Business Mailing Address
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Address Line | 27540 YNEZ RD STE J15
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City | TEMECULA
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State | CA
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Zip | 92591-4604
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Country | US
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Telephone | 951-506-0021
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Fax | 951-506-0022
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | ARTHUR KIM
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Credential | O.D.
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Telephone | 509-449-3030
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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 | 10783
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License Number State | CA
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