Provider Demographics
NPI:1275739260
Name:VISUAL SPECTRUM
Entity Type:Organization
Organization Name:VISUAL SPECTRUM
Other - Org Name:STERLING OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PING
Authorized Official - Middle Name:DONG
Authorized Official - Last Name:GUAN
Authorized Official - Suffix:
Authorized Official - Credentials:RDO
Authorized Official - Phone:626-825-8197
Mailing Address - Street 1:5544 WHITTIER BL.
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:CA
Mailing Address - Zip Code:90022
Mailing Address - Country:US
Mailing Address - Phone:323-721-4488
Mailing Address - Fax:323-721-4788
Practice Address - Street 1:5544 WHITTIER BL.
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:CA
Practice Address - Zip Code:90022
Practice Address - Country:US
Practice Address - Phone:323-721-4488
Practice Address - Fax:323-721-4788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD 7022156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD 7022OtherREGISTERED DISPENSING OPT