Provider Demographics
NPI:1649694571
Name:VISUAL EYES OPTOMETRY INC
Entity type:Organization
Organization Name:VISUAL EYES OPTOMETRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:HYUN JOO
Authorized Official - Last Name:KIM- LAUBACH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:925-463-7330
Mailing Address - Street 1:4555 HOPYARD RD STE C-19
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-2771
Mailing Address - Country:US
Mailing Address - Phone:925-463-7330
Mailing Address - Fax:925-463-7337
Practice Address - Street 1:4555 HOPYARD RD STE C-19
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-2771
Practice Address - Country:US
Practice Address - Phone:925-463-7330
Practice Address - Fax:925-463-7337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT9720152WC0802X
CAOPT9880152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty