Provider Demographics
NPI:1720686140
Name:LENS 4 LESS OPTICAL, INC.
Entity Type:Organization
Organization Name:LENS 4 LESS OPTICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIBOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-593-9357
Mailing Address - Street 1:141 CALLE MARIBEL
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-3120
Mailing Address - Country:US
Mailing Address - Phone:760-593-9357
Mailing Address - Fax:
Practice Address - Street 1:343 W FELICITA AVE # 10
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-6515
Practice Address - Country:US
Practice Address - Phone:760-975-3729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty