Provider Demographics
NPI:1114061207
Name:DR. LEONARD H. FORBES, O.D.
Entity Type:Organization
Organization Name:DR. LEONARD H. FORBES, O.D.
Other - Org Name:THE VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FORBES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-367-1015
Mailing Address - Street 1:12737 GLENOAKS BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-4724
Mailing Address - Country:US
Mailing Address - Phone:818-376-1015
Mailing Address - Fax:818-367-3593
Practice Address - Street 1:12737 GLENOAKS BLVD STE 3
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-4724
Practice Address - Country:US
Practice Address - Phone:818-367-1015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4873T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGSD005540Medicaid
CAOP4873OtherMEDICARE ID - TYPE UNSPECIFIED
CAOP4873Medicare UPIN
CAOP4873Medicare PIN