Provider Demographics
NPI:1750508974
Name:FIRSTSIGHT VISION SERVICES, INC.
Entity Type:Organization
Organization Name:FIRSTSIGHT VISION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-920-5008
Mailing Address - Street 1:1202 MONTE VISTA AVE
Mailing Address - Street 2:SUITE 17
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-8208
Mailing Address - Country:US
Mailing Address - Phone:909-920-5008
Mailing Address - Fax:909-932-0062
Practice Address - Street 1:1202 MONTE VISTA AVE
Practice Address - Street 2:SUITE 17
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-8208
Practice Address - Country:US
Practice Address - Phone:909-920-5008
Practice Address - Fax:909-932-0062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA933342152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA933342OtherDMHC PLAN NUMBER