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General NPI Number Information
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NPI Number | 1750176533
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Entity Type | Organization
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Legal Business Name | EYE SEA OPTOMETRY APC
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Dates
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Enumeration Date | 04/11/2025
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 231 C ST
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City | DAVIS
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State | CA
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Zip | 95616-4521
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Country | US
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Telephone | 530-758-4000
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Fax | 530-758-4016
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Provider Business Mailing Address
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Address Line | 231 C ST
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City | DAVIS
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State | CA
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Zip | 95616-4521
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Country | US
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Telephone | 530-758-4000
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Fax | 530-758-4016
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL/OD/OWNER
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Name | GAGANJOT KAUR VIRK
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Credential | OD
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Telephone | 530-758-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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