Provider Demographics
NPI:1679938989
Name:EAST HILLS FAMILY OPTOMETRY
Entity Type:Organization
Organization Name:EAST HILLS FAMILY OPTOMETRY
Other - Org Name:EAST HILLS VISION OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:NGO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:408-506-1539
Mailing Address - Street 1:1080 S WHITE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-3821
Mailing Address - Country:US
Mailing Address - Phone:408-272-3002
Mailing Address - Fax:408-272-0820
Practice Address - Street 1:1080 S WHITE RD
Practice Address - Street 2:SUITE A
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-3821
Practice Address - Country:US
Practice Address - Phone:408-272-3002
Practice Address - Fax:408-272-0820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-31
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14536TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty