Provider Demographics
NPI:1346830031
Name:CALIFORNIA OPTOMETRIC CENTER
Entity Type:Organization
Organization Name:CALIFORNIA OPTOMETRIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAHIL
Authorized Official - Middle Name:ANUP
Authorized Official - Last Name:DOSAJ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:909-797-0134
Mailing Address - Street 1:34806 YUCAIPA BLVD
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-4235
Mailing Address - Country:US
Mailing Address - Phone:909-797-0134
Mailing Address - Fax:909-797-0137
Practice Address - Street 1:34806 YUCAIPA BLVD
Practice Address - Street 2:
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399-4235
Practice Address - Country:US
Practice Address - Phone:909-797-0134
Practice Address - Fax:909-797-0137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-26
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty