Provider Demographics
NPI:1447566062
Name:EYECONIC, INC.
Entity Type:Organization
Organization Name:EYECONIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PROFESSIONAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRCHNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:949-754-5062
Mailing Address - Street 1:10875 INTERNATIONAL DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7371
Mailing Address - Country:US
Mailing Address - Phone:916-851-4680
Mailing Address - Fax:
Practice Address - Street 1:10875 INTERNATIONAL DR
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-7371
Practice Address - Country:US
Practice Address - Phone:916-851-4680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier