Provider Demographics
NPI:1225298409
Name:FRAMES, LENSES, ETC
Entity Type:Organization
Organization Name:FRAMES, LENSES, ETC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUKACHEVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-317-2093
Mailing Address - Street 1:5741 CARLTON WAY
Mailing Address - Street 2:#210
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-6754
Mailing Address - Country:US
Mailing Address - Phone:323-317-2093
Mailing Address - Fax:
Practice Address - Street 1:7626 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-6409
Practice Address - Country:US
Practice Address - Phone:323-317-2093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7338332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site