Provider Demographics
NPI:1104039544
Name:HILLCREST OPTICAL INC.
Entity Type:Organization
Organization Name:HILLCREST OPTICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:STEINHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:ABO NCLE RDO
Authorized Official - Phone:619-298-3586
Mailing Address - Street 1:420 THORN ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-5708
Mailing Address - Country:US
Mailing Address - Phone:619-298-3586
Mailing Address - Fax:619-298-3682
Practice Address - Street 1:420 THORN ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5708
Practice Address - Country:US
Practice Address - Phone:619-298-3586
Practice Address - Fax:619-298-3682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD6964156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty