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General NPI Number Information
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NPI Number | 1528506870
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Entity Type | Organization
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Legal Business Name | EYE C YOU OPTOMETRY, INC
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Dates
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Enumeration Date | 02/07/2017
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 1299 UNIVERSITY AVE SUITE 103
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City | RIVERSIDE
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State | CA
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Zip | 92507-7235
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Country | US
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Telephone | 951-248-0088
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Fax | 951-248-0099
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Provider Business Mailing Address
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Address Line | 1299 UNIVERSITY AVE SUITE 103
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City | RIVERSIDE
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State | CA
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Zip | 92507-7235
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Country | US
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Telephone | 951-248-0088
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Fax | 951-248-0099
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Authorized Official
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Title or Position | PRESIDENT
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Name | PENN TRAN
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Credential | O.D.
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Telephone | 951-248-0088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 12521T
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License Number State | CA
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