Provider Demographics
NPI:1205016680
Name:FIRSTSIGHT VISION SERVICES, INC.
Entity Type:Organization
Organization Name:FIRSTSIGHT VISION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIDELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-920-5008
Mailing Address - Street 1:1202 MONTE VISTA AVE STE 17
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-8216
Mailing Address - Country:US
Mailing Address - Phone:909-920-5005
Mailing Address - Fax:888-241-9266
Practice Address - Street 1:4300 MISSOURI FLAT RD
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-6811
Practice Address - Country:US
Practice Address - Phone:560-626-9287
Practice Address - Fax:530-626-9238
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIRSTSIGHT VISION SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty