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General NPI Number Information
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NPI Number | 1598614968
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Entity Type | Organization
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Legal Business Name | MODERN SIGHT OPTOMETRIC CORPORATION
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Dates
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Enumeration Date | 01/27/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 950 CODDINGTOWN CTR
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City | SANTA ROSA
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State | CA
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Zip | 95401-3512
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Country | US
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Telephone | 707-528-3876
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Fax |
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Provider Business Mailing Address
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Address Line | 2108 N ST STE N
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City | SACRAMENTO
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State | CA
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Zip | 95816-5712
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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 | PRESIDENT
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Name | SOPHIA MOH
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Credential | OD
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Telephone | 510-463-4669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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