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General NPI Number Information
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NPI Number | 1598658478
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Entity Type | Organization
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Legal Business Name | SM OPTICAL INC
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 730 CAMINO RAMON STE 170
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City | DANVILLE
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State | CA
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Zip | 94526-4263
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Country | US
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Telephone | 925-964-1010
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Fax | 925-964-1011
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Provider Business Mailing Address
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Address Line | 528 BURLINGTON DR
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City | TRACY
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State | CA
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Zip | 95376-4921
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Country | US
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Telephone | 510-300-7944
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Fax |
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Authorized Official
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Title or Position | OPTICIAN
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Name | SOBHY SERGIOUS
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Credential | DO
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Telephone | 510-300-7944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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