MEDICARE: ADVANCED EYE ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPT12726	CA
2	152WL0500X	Low Vision Rehabilitation Optometrist	OPT12795	CA
3	207W00000X	Ophthalmology Physician	00G805732	CA
4	332B00000X	Durable Medical Equipment & Medical Supplies	5797900001	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043345051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED EYE ASSOCIATES

Provider Business Mailing Address
First Line	:	200 JOSE FIGUERES AVE
Second Line	:	SUITE 350
City	:	SAN JOSE
State	:	CA
Zip	:	95116-1585
Country	:	US
Telephone Number	:	408-923-8138
Fax Number	:	408-923-8214

Provider Business Practice Location Address
First Line	:	200 JOSE FIGUERES AVE
Second Line	:	SUITE 350
City	:	SAN JOSE
State	:	CA
Zip	:	95116-1585
Country	:	US
Telephone Number	:	408-923-8138
Fax Number	:	408-923-8214

Authorized Official
Title or Position	:	CEO
Name	:	DR. DANNY LUONG
Credential	:	M.D.
Telephone Number	:	408-923-8138

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	02/13/2013

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Directions to “ADVANCED EYE ASSOCIATES ” Practice Location

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