Provider Demographics
NPI:1336267038
Name:VISUALEYES, INC.
Entity Type:Organization
Organization Name:VISUALEYES, INC.
Other - Org Name:SITE FOR SORE EYES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CAMBRA
Authorized Official - Suffix:
Authorized Official - Credentials:RSLD
Authorized Official - Phone:510-301-8317
Mailing Address - Street 1:1209 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-0129
Mailing Address - Country:US
Mailing Address - Phone:707-442-2922
Mailing Address - Fax:707-442-7206
Practice Address - Street 1:1209 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-0129
Practice Address - Country:US
Practice Address - Phone:707-442-2922
Practice Address - Fax:707-442-7206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASL4921156FX1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmicGroup - Single Specialty