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General NPI Number Information
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NPI Number | 1831290014
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Entity Type | Organization
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Legal Business Name | MICHAEL'S OPTICAL INC.
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 145 NIBLICK RD
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City | PASO ROBLES
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State | CA
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Zip | 93446-4844
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Country | US
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Telephone | 805-238-5770
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Fax | 805-238-4047
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Provider Business Mailing Address
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Address Line | 8300 EL CAMINO REAL B
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City | ATASCADERO
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State | CA
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Zip | 93422-5358
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Country | US
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Telephone | 805-466-5770
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Fax | 805-466-8501
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL GENE NUTT
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Credential |
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Telephone | 805-466-5770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | D 3272
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License Number State | CA
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