Provider Demographics
NPI:1376660886
Name:FASHION OPTICAL CORPORATION
Entity Type:Organization
Organization Name:FASHION OPTICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-821-0222
Mailing Address - Street 1:1220 S GOLDEN WEST AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-7484
Mailing Address - Country:US
Mailing Address - Phone:626-821-0222
Mailing Address - Fax:626-821-9420
Practice Address - Street 1:1220 S GOLDEN WEST AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7484
Practice Address - Country:US
Practice Address - Phone:626-821-0222
Practice Address - Fax:626-821-9420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD4201291U00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered291U00000XLaboratoriesClinical Medical Laboratory
Not Answered332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADX004201FOtherMEDICAL
CA09310OtherMEDICAL EYE SERVICES
CA51046OtherDAVIS VISION
CAFO20092OtherSPECTERA
CACA4201OtherEYEMED VISIONCARE
CA58119OtherSAFEGUARD