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General NPI Number Information
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NPI Number | 1841404662
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Entity Type | Organization
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Legal Business Name | 20 20 OPTOMETRY OF SILICON VALLEY
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 07/19/2014
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Provider Practice Location Address
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Address Line | 2555 N 1ST ST
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City | SAN JOSE
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State | CA
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Zip | 95131-1003
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Country | US
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Telephone | 408-433-0800
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Fax | 408-577-0849
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Provider Business Mailing Address
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Address Line | 2555 N 1ST ST
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City | SAN JOSE
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State | CA
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Zip | 95131-1003
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Country | US
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Telephone | 408-433-0800
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Fax | 408-577-0849
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEANETTE LEE
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Credential | O.D.
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Telephone | 408-433-0800
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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 | 10538
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License Number State | CA
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