Provider Demographics
NPI:1215387469
Name:BESPECTACLED EYE CARE OPTOMETRY CORP.
Entity Type:Organization
Organization Name:BESPECTACLED EYE CARE OPTOMETRY CORP.
Other - Org Name:SABRINA GRAZIANO SHIVELY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:P
Authorized Official - Last Name:GRAZIANO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:661-489-7765
Mailing Address - Street 1:5603 AUBURN ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-2978
Mailing Address - Country:US
Mailing Address - Phone:661-489-7765
Mailing Address - Fax:
Practice Address - Street 1:5603 AUBURN ST UNIT A
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-2979
Practice Address - Country:US
Practice Address - Phone:661-489-7765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT14733TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty