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General NPI Number Information
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NPI Number | 1477756617
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Entity Type | Organization
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Legal Business Name | 2020 OPTICAL
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 1127 4TH ST
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City | SAN RAFAEL
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State | CA
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Zip | 94901-3006
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Country | US
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Telephone | 415-453-2020
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Fax | 415-459-7262
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Provider Business Mailing Address
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Address Line | 1127 4TH ST
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City | SAN RAFAEL
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State | CA
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Zip | 94901-3006
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Country | US
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Telephone | 415-453-2020
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Fax | 415-459-7262
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID SCHWARTZ
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Credential | FNAO
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Telephone | 415-453-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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