Provider Demographics
NPI:1275087769
Name:SCHAIN OPTICAL LLC
Entity Type:Organization
Organization Name:SCHAIN OPTICAL LLC
Other - Org Name:SECOND STREET OPTIQUE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:SCHAIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:RDO
Authorized Official - Phone:562-595-2887
Mailing Address - Street 1:4810 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-5312
Mailing Address - Country:US
Mailing Address - Phone:562-595-2887
Mailing Address - Fax:
Practice Address - Street 1:4810 E 2ND ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-5312
Practice Address - Country:US
Practice Address - Phone:562-595-2887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-12
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD7679332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier