Provider Demographics
NPI:1700446432
Name:EYESCHOICE OPTOMETRY
Entity Type:Organization
Organization Name:EYESCHOICE OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:SE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:310-985-9290
Mailing Address - Street 1:1730 E 17TH ST STE G
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8624
Mailing Address - Country:US
Mailing Address - Phone:714-543-9489
Mailing Address - Fax:
Practice Address - Street 1:1730 E 17TH ST STE G
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-8624
Practice Address - Country:US
Practice Address - Phone:714-543-9489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty