Provider Demographics
NPI:1295892040
Name:EAST HILLS VISION CARE, AN OPTOMETRIC CORPORATION
Entity type:Organization
Organization Name:EAST HILLS VISION CARE, AN OPTOMETRIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:JUNG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:408-272-3002
Mailing Address - Street 1:1080 S WHITE RD STE A
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-3821
Mailing Address - Country:US
Mailing Address - Phone:408-272-3002
Mailing Address - Fax:408-272-0820
Practice Address - Street 1:1080 S WHITE RD STE A
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-3821
Practice Address - Country:US
Practice Address - Phone:408-272-3002
Practice Address - Fax:408-272-0820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACOR 646152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty