Provider Demographics
NPI:1184925596
Name:SUNFOREST VISION CENTER INC
Entity type:Organization
Organization Name:SUNFOREST VISION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:YAP
Authorized Official - Last Name:SIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-475-9251
Mailing Address - Street 1:3915 SUNFOREST CT
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4453
Mailing Address - Country:US
Mailing Address - Phone:419-475-9251
Mailing Address - Fax:419-475-1407
Practice Address - Street 1:3915 SUNFOREST CT
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4453
Practice Address - Country:US
Practice Address - Phone:419-475-9251
Practice Address - Fax:419-475-1407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-03-4485S261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0372941OtherMEDICARE
OH0194356Medicaid
OH0372941OtherMEDICARE