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General NPI Number Information
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NPI Number | 1982883716
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Entity Type | Organization
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Legal Business Name | US OPTICAL INC
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Dates
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Enumeration Date | 10/29/2007
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Last Update Date | 10/29/2007
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Provider Practice Location Address
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Address Line | 29574 HAZEL GLEN RD
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City | MURRIETA
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State | CA
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Zip | 92563-6798
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Country | US
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Telephone | 951-526-3751
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Fax |
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Provider Business Mailing Address
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Address Line | 5230 NORTHFIELD RD
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City | MAPLE HEIGHTS
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State | OH
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Zip | 44137-2467
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Country | US
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Telephone | 216-332-1711
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MR. HANI SADDIC
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Credential | LDO
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Telephone | 951-526-3751
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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 | S4217
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License Number State | OH
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