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General NPI Number Information
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NPI Number | 1760865604
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Entity Type | Organization
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Legal Business Name | PACVISION INCORPORATED
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Dates
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Enumeration Date | 07/09/2015
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Last Update Date | 01/13/2016
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Provider Practice Location Address
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Address Line | 6930 65TH ST SUITE # 113
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City | SACRAMENTO
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State | CA
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Zip | 95823-2343
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Country | US
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Telephone | 916-395-7571
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Fax | 916-395-7195
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Provider Business Mailing Address
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Address Line | 6930 65TH ST SUITE # 113
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City | SACRAMENTO
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State | CA
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Zip | 95823-2343
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Country | US
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Telephone | 916-395-7571
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Fax | 916-395-7195
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Authorized Official
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Title or Position | CEO
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Name | DR. SANG HUU TRAN
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Credential | OD
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Telephone | 916-395-7571
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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 | CA11224
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License Number State | CA
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