Provider Demographics
NPI:1295026698
Name:FOCUS OPTOMETRIC GROUP, INC
Entity Type:Organization
Organization Name:FOCUS OPTOMETRIC GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MAY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:510-493-3357
Mailing Address - Street 1:46871 WARM SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-7922
Mailing Address - Country:US
Mailing Address - Phone:510-493-3357
Mailing Address - Fax:
Practice Address - Street 1:46871 WARM SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-7922
Practice Address - Country:US
Practice Address - Phone:510-493-3357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11240T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFC449AMedicare PIN