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General NPI Number Information
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NPI Number | 1255142980
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Entity Type | Organization
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Legal Business Name | FIRST OPTOMETRIC CARE OF NORTHERN CALIFORNIA PC
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 20630 STEVENS CREEK BLVD
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City | CUPERTINO
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State | CA
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Zip | 95014-2120
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Country | US
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Telephone | 407-777-9000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 744853
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City | LOS ANGELES
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State | CA
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Zip | 90074-4853
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | BRITTANY HARRISON
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Credential |
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Telephone | 512-316-4603
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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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