Provider Demographics
NPI:1508478850
Name:VISION SPECIALISTS OF CALIFORNIA, PC
Entity Type:Organization
Organization Name:VISION SPECIALISTS OF CALIFORNIA, PC
Other - Org Name:KHAN VISION SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-501-9050
Mailing Address - Street 1:233 LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2122
Mailing Address - Country:US
Mailing Address - Phone:619-501-9050
Mailing Address - Fax:619-501-9054
Practice Address - Street 1:233 LEWIS ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2122
Practice Address - Country:US
Practice Address - Phone:619-501-9050
Practice Address - Fax:619-501-9054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-18
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma SpecialistGroup - Single Specialty