Provider Demographics
NPI:1033386594
Name:HART OPTICAL COMPANY OF LA MESA
Entity Type:Organization
Organization Name:HART OPTICAL COMPANY OF LA MESA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:EMERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-466-6825
Mailing Address - Street 1:8685 LA MESA BLVD
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-3903
Mailing Address - Country:US
Mailing Address - Phone:619-466-6825
Mailing Address - Fax:619-462-9239
Practice Address - Street 1:8685 LA MESA BLVD
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-3903
Practice Address - Country:US
Practice Address - Phone:619-466-6825
Practice Address - Fax:619-462-9239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty