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General NPI Number Information
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NPI Number | 1689932840
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Entity Type | Organization
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Legal Business Name | HACIENDA PARK OPTOMETRY, INC
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Dates
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Enumeration Date | 04/25/2012
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Last Update Date | 05/02/2012
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Provider Practice Location Address
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Address Line | 4825 HOPYARD RD STE F1
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City | PLEASANTON
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State | CA
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Zip | 94588-2772
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Country | US
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Telephone | 925-227-0400
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Fax | 925-227-0730
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Provider Business Mailing Address
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Address Line | 4825 HOPYARD RD STE F1
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City | PLEASANTON
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State | CA
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Zip | 94588-2772
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Country | US
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Telephone | 925-227-0400
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Fax | 925-227-0730
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LINDA ANNE CUSHING
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Credential | O.D.
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Telephone | 925-227-0400
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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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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9246T
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9502T
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License Number State | CA
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