Provider Demographics
NPI:1083781769
Name:BRIGHT EYE CARE
Entity Type:Organization
Organization Name:BRIGHT EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-282-7579
Mailing Address - Street 1:419 N ATLANTIC BLVD # 104-105
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-7701
Mailing Address - Country:US
Mailing Address - Phone:626-282-7579
Mailing Address - Fax:626-282-6841
Practice Address - Street 1:419 N ATLANTIC BLVD # 104-105
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-7701
Practice Address - Country:US
Practice Address - Phone:626-282-7579
Practice Address - Fax:626-282-6841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOP9461T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0094610Medicaid
CAOP9461Medicare ID - Type Unspecified
U02826Medicare UPIN