Provider Demographics
NPI:1841561495
Name:CLEAR FOCUS OPTOMETRY, INC.
Entity Type:Organization
Organization Name:CLEAR FOCUS OPTOMETRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NGHI
Authorized Official - Middle Name:UYEN
Authorized Official - Last Name:DUONG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:760-744-0767
Mailing Address - Street 1:635B S RANCHO SANTA FE RD
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-3973
Mailing Address - Country:US
Mailing Address - Phone:760-744-0767
Mailing Address - Fax:760-744-2892
Practice Address - Street 1:635B S RANCHO SANTA FE RD
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-3973
Practice Address - Country:US
Practice Address - Phone:760-744-0767
Practice Address - Fax:760-744-2892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12803152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFX960AMedicare PIN