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General NPI Number Information
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NPI Number | 1891065918
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Entity Type | Organization
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Legal Business Name | AGAPE OPTICAL INC
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Dates
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Enumeration Date | 01/05/2012
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 17520 CASTLETON ST STE 105A
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City | CITY OF INDUSTRY
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State | CA
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Zip | 91748-5798
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Country | US
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Telephone | 626-715-3308
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Fax |
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Provider Business Mailing Address
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Address Line | 17520 CASTLETON ST SUITE 105A
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City | CITY OF INDUSTRY
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State | CA
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Zip | 91748-1701
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Country | US
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Telephone | 626-715-3308
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JENNY TSAI
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Credential |
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Telephone | 626-581-3307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | D7611
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License Number State | CA
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