Provider Demographics
NPI:1760030324
Name:EYESOURCE SF INC.
Entity Type:Organization
Organization Name:EYESOURCE SF INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANGELITO
Authorized Official - Middle Name:
Authorized Official - Last Name:ACUNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-374-0212
Mailing Address - Street 1:140 BATTERY ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-4903
Mailing Address - Country:US
Mailing Address - Phone:415-421-2020
Mailing Address - Fax:415-421-1004
Practice Address - Street 1:140 BATTERY ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-4903
Practice Address - Country:US
Practice Address - Phone:415-421-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier