Provider Demographics
NPI:1093425100
Name:SARAH FRASSATO, O.D., A PROFESSIONAL OPTOMETRIC CORPORATION
Entity Type:Organization
Organization Name:SARAH FRASSATO, O.D., A PROFESSIONAL OPTOMETRIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/ OWNER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:FRASSATO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:312-804-8726
Mailing Address - Street 1:4631 SEPULVEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-2156
Mailing Address - Country:US
Mailing Address - Phone:312-804-8726
Mailing Address - Fax:
Practice Address - Street 1:249 AVENIDA DEL NORTE
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-5702
Practice Address - Country:US
Practice Address - Phone:312-804-8726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty