Provider Demographics
NPI:1043522485
Name:AV OPTOMETRY, INC.
Entity Type:Organization
Organization Name:AV OPTOMETRY, INC.
Other - Org Name:EYE CONTACT OPTOMETRIC GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WENG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:510-299-2025
Mailing Address - Street 1:2191 MOWRY AVE.
Mailing Address - Street 2:SUITE 500-F
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538
Mailing Address - Country:US
Mailing Address - Phone:510-742-1004
Mailing Address - Fax:510-742-1013
Practice Address - Street 1:2191 MOWRY AVE
Practice Address - Street 2:SUITE 500-F
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1725
Practice Address - Country:US
Practice Address - Phone:510-742-1004
Practice Address - Fax:510-742-1013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11492T152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty