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General NPI Number Information
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NPI Number | 1932156122
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Entity Type | Organization
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Legal Business Name | MOUNTAIN VIEW OPTOMETRY AND CONTACT LENS CLINIC
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 02/04/2008
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Provider Practice Location Address
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Address Line | 495 CASTRO ST SUITE 200
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94041-2086
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Country | US
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Telephone | 650-967-6649
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Fax | 650-967-0237
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Provider Business Mailing Address
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Address Line | 495 CASTRO ST SUITE 200
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94041-2086
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Country | US
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Telephone | 650-967-6649
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Fax | 650-967-0237
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. KENNETH N SCHWADERER
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Credential | OD
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Telephone | 650-967-6649
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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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