Provider Demographics
NPI:1467639047
Name:GOOD EYE INC
Entity Type:Organization
Organization Name:GOOD EYE INC
Other - Org Name:GOOD EYE OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GOZINI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:310-440-9500
Mailing Address - Street 1:11718 BARRINGTON CT
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-2930
Mailing Address - Country:US
Mailing Address - Phone:310-440-9500
Mailing Address - Fax:310-440-4405
Practice Address - Street 1:11718 BARRINGTON CT
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-2930
Practice Address - Country:US
Practice Address - Phone:310-440-9500
Practice Address - Fax:310-440-4405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-26
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFNP 3132152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACI171AMedicare PIN