Provider Demographics
NPI:1336328756
Name:AB CEE OPTICAL INC
Entity Type:Organization
Organization Name:AB CEE OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEKTOR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:323-874-2020
Mailing Address - Street 1:7272 W SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-3410
Mailing Address - Country:US
Mailing Address - Phone:323-874-2020
Mailing Address - Fax:
Practice Address - Street 1:7272 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-3410
Practice Address - Country:US
Practice Address - Phone:323-874-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD6944332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADX002648FMedicaid
CADX002648FMedicaid