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General NPI Number Information
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NPI Number | 1972971901
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Entity Type | Organization
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Legal Business Name | BRIGHT VISION OPTOMETRY
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Dates
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Enumeration Date | 09/08/2015
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Last Update Date | 09/08/2015
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Provider Practice Location Address
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Address Line | 2935 CHINO AVE SUITE E3
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City | CHINO HILLS
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State | CA
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Zip | 91709-3575
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Country | US
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Telephone | 909-627-1111
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Fax | 909-627-1112
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Provider Business Mailing Address
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Address Line | 2935 CHINO AVE SUITE E3
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City | CHINO HILLS
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State | CA
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Zip | 91709-3575
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Country | US
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Telephone | 909-627-1111
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Fax | 909-627-1112
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | STEVEN SOONG
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Credential | O.D.
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Telephone | 626-430-8085
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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 | 14005
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 14716
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License Number State | CA
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