Provider Demographics
NPI:1922395417
Name:VISION PLANET OPTOMETRY, INC
Entity Type:Organization
Organization Name:VISION PLANET OPTOMETRY, INC
Other - Org Name:VISION PLANET OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHASE
Authorized Official - Middle Name:
Authorized Official - Last Name:YI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:714-236-0741
Mailing Address - Street 1:7013 KATELLA AVE
Mailing Address - Street 2:STE B
Mailing Address - City:STANTON
Mailing Address - State:CA
Mailing Address - Zip Code:90680-4375
Mailing Address - Country:US
Mailing Address - Phone:714-236-0741
Mailing Address - Fax:714-236-9347
Practice Address - Street 1:7013 KATELLA AVE
Practice Address - Street 2:STE B
Practice Address - City:STANTON
Practice Address - State:CA
Practice Address - Zip Code:90680-4375
Practice Address - Country:US
Practice Address - Phone:714-236-0741
Practice Address - Fax:714-236-9347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-05
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12151 T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty