Provider Demographics
NPI:1225603509
Name:STEEL OPTICAL INC PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:STEEL OPTICAL INC PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VIGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:626-297-1432
Mailing Address - Street 1:1477 W LAKE ST UNIT 408
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-5117
Mailing Address - Country:US
Mailing Address - Phone:626-297-1432
Mailing Address - Fax:
Practice Address - Street 1:995 BLUE GENTIAN RD
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55121-1542
Practice Address - Country:US
Practice Address - Phone:626-272-5693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty