Provider Demographics
NPI:1538508932
Name:SCANQUEST OPHTHALMIC SERVICES
Entity Type:Organization
Organization Name:SCANQUEST OPHTHALMIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:GUY
Authorized Official - Last Name:DESFORGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-703-2874
Mailing Address - Street 1:2375 OLD RANCH RD
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-6733
Mailing Address - Country:US
Mailing Address - Phone:760-703-2874
Mailing Address - Fax:760-741-7420
Practice Address - Street 1:2375 OLD RANCH RD
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92027-6733
Practice Address - Country:US
Practice Address - Phone:760-703-2874
Practice Address - Fax:760-741-7420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156F00000XEye and Vision Services ProvidersTechnician/TechnologistGroup - Single Specialty