Provider Demographics
NPI:1497275440
Name:2 SEE OPTOMETRY
Entity Type:Organization
Organization Name:2 SEE OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:JUNGHYE
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:818-832-4646
Mailing Address - Street 1:5060 ANGELES CREST HWY
Mailing Address - Street 2:
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-2368
Mailing Address - Country:US
Mailing Address - Phone:818-790-5670
Mailing Address - Fax:
Practice Address - Street 1:3115 FOOTHILL BLVD STE D
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-4237
Practice Address - Country:US
Practice Address - Phone:818-832-4646
Practice Address - Fax:818-368-9898
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VISIONMAX OPTOMETRY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-21
Last Update Date:2017-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11143T261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0111430Medicaid