Provider Demographics
NPI:1407886427
Name:EYE CARE WEST OPTOMETRY OC
Entity Type:Organization
Organization Name:EYE CARE WEST OPTOMETRY OC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:949-215-0505
Mailing Address - Street 1:26750 TOWNE CENTRE DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-2841
Mailing Address - Country:US
Mailing Address - Phone:949-215-0505
Mailing Address - Fax:949-273-5029
Practice Address - Street 1:26750 TOWNE CENTRE DR
Practice Address - Street 2:SUITE E
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2841
Practice Address - Country:US
Practice Address - Phone:949-215-0505
Practice Address - Fax:949-273-5029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19774Medicare PIN