Provider Demographics
NPI:1760865604
Name:PACVISION INCORPORATED
Entity Type:Organization
Organization Name:PACVISION INCORPORATED
Other - Org Name:PACIFIC VISION OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SANG
Authorized Official - Middle Name:HUU
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:916-395-7571
Mailing Address - Street 1:6930 65TH ST
Mailing Address - Street 2:SUITE # 113
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2343
Mailing Address - Country:US
Mailing Address - Phone:916-395-7571
Mailing Address - Fax:916-395-7195
Practice Address - Street 1:6930 65TH ST
Practice Address - Street 2:SUITE # 113
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2343
Practice Address - Country:US
Practice Address - Phone:916-395-7571
Practice Address - Fax:916-395-7195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-09
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA11224152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty