Provider Demographics
NPI:1619372166
Name:REINA Y PEREZ A PROFESSIONAL CORP.
Entity Type:Organization
Organization Name:REINA Y PEREZ A PROFESSIONAL CORP.
Other - Org Name:FOSTER CITY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REINA
Authorized Official - Middle Name:YUAN
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:650-573-6245
Mailing Address - Street 1:939 EDGEWATER BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:FOSTER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94404-3760
Mailing Address - Country:US
Mailing Address - Phone:650-573-6245
Mailing Address - Fax:650-573-1466
Practice Address - Street 1:939 EDGEWATER BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:FOSTER CITY
Practice Address - State:CA
Practice Address - Zip Code:94404-3760
Practice Address - Country:US
Practice Address - Phone:650-573-6245
Practice Address - Fax:650-573-1466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12091T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty