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General NPI Number Information
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NPI Number | 1962754481
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Entity Type | Organization
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Legal Business Name | ISEE OPTOMETRY
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Dates
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Enumeration Date | 10/08/2012
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Last Update Date | 11/08/2012
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Provider Practice Location Address
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Address Line | 3151 SENTER RD SUITE 130
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City | SAN JOSE
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State | CA
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Zip | 95111-1370
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Country | US
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Telephone | 408-960-6479
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Fax | 408-912-5843
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Provider Business Mailing Address
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Address Line | 334 SANTANA ROW APT 342
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City | SAN JOSE
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State | CA
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Zip | 95128-2026
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Country | US
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Telephone | 408-960-6479
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Fax | 408-912-5843
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAM H VOTRAN
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Credential | OD
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Telephone | 408-960-6479
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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 | OPT 14241
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License Number State | CA
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