Provider Demographics
NPI:1134799406
Name:AVCOPTOMETRY, INC
Entity type:Organization
Organization Name:AVCOPTOMETRY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:T
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:951-243-3337
Mailing Address - Street 1:14140 MERIDIAN PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92518-3043
Mailing Address - Country:US
Mailing Address - Phone:951-243-3337
Mailing Address - Fax:951-243-6868
Practice Address - Street 1:14140 MERIDIAN PKWY STE 101
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92518-3043
Practice Address - Country:US
Practice Address - Phone:951-243-3337
Practice Address - Fax:951-243-6868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
114434454OtherNPI