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General NPI Number Information
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NPI Number | 1649694571
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Entity Type | Organization
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Legal Business Name | VISUAL EYES OPTOMETRY INC
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Dates
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Enumeration Date | 02/12/2014
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 4555 HOPYARD RD STE C-19
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City | PLEASANTON
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State | CA
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Zip | 94588-2771
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Country | US
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Telephone | 925-463-7330
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Fax | 925-463-7337
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Provider Business Mailing Address
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Address Line | 4555 HOPYARD RD STE C-19
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City | PLEASANTON
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State | CA
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Zip | 94588-2771
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Country | US
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Telephone | 925-463-7330
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Fax | 925-463-7337
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUSAN HYUN JOO KIM- LAUBACH
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Credential | O.D.
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Telephone | 925-463-7330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OPT9720
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | OPT9880
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License Number State | CA
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