Provider Demographics
NPI:1497039630
Name:ISEE OPTOMETRY
Entity Type:Organization
Organization Name:ISEE OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAM
Authorized Official - Middle Name:HAI
Authorized Official - Last Name:VOTRAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:510-790-4910
Mailing Address - Street 1:648 BASALT DR
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94589-2100
Mailing Address - Country:US
Mailing Address - Phone:510-790-4910
Mailing Address - Fax:510-796-4777
Practice Address - Street 1:35149 NEWARK BLVD
Practice Address - Street 2:STE C
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-1209
Practice Address - Country:US
Practice Address - Phone:510-790-4910
Practice Address - Fax:510-796-4777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 14241152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty