Provider Demographics
NPI:1265001358
Name:EYE 2 EYE OPTICAL INC
Entity Type:Organization
Organization Name:EYE 2 EYE OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BAVLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-995-1098
Mailing Address - Street 1:2370 CRENSHAW BLVD STE O
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-3352
Mailing Address - Country:US
Mailing Address - Phone:424-558-3455
Mailing Address - Fax:424-558-3466
Practice Address - Street 1:2370 CRENSHAW BLVD STE O
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-3352
Practice Address - Country:US
Practice Address - Phone:424-558-3455
Practice Address - Fax:424-558-3466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7905550001Medicaid