Provider Demographics
NPI:1932692167
Name:RL OPTOMETRY INC
Entity Type:Organization
Organization Name:RL OPTOMETRY INC
Other - Org Name:EAST BAY VISION CENTER OPTOMETRY, PLEASANTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/O.D.
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:925-462-1100
Mailing Address - Street 1:670 MCCORMICK ST
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-1110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2709 STONERIDGE DR STE 112
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-8358
Practice Address - Country:US
Practice Address - Phone:925-462-1100
Practice Address - Fax:925-462-6600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACAOPT33420152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty