Provider Demographics
NPI:1851645758
Name:NORTH TORRANCE OPTOMETRY
Entity Type:Organization
Organization Name:NORTH TORRANCE OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:TAKAO
Authorized Official - Last Name:SHIMAZAKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:310-532-8900
Mailing Address - Street 1:17430 CRENSHAW BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-3400
Mailing Address - Country:US
Mailing Address - Phone:310-532-8900
Mailing Address - Fax:310-532-4079
Practice Address - Street 1:17430 CRENSHAW BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-3400
Practice Address - Country:US
Practice Address - Phone:310-532-8900
Practice Address - Fax:310-532-4079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12858T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty