Provider Demographics
NPI:1255509691
Name:LA HABRA HILLS OPTOMETRY, INC.
Entity Type:Organization
Organization Name:LA HABRA HILLS OPTOMETRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CELESTE
Authorized Official - Middle Name:LIEN
Authorized Official - Last Name:PINKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:562-697-6733
Mailing Address - Street 1:601 E WHITTIER BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-3972
Mailing Address - Country:US
Mailing Address - Phone:562-697-6733
Mailing Address - Fax:562-697-8303
Practice Address - Street 1:601 E WHITTIER BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-3972
Practice Address - Country:US
Practice Address - Phone:562-697-6733
Practice Address - Fax:562-697-8303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6306640001Medicare NSC