Provider Demographics
NPI:1831369354
Name:VISUALEYES, LLC
Entity type:Organization
Organization Name:VISUALEYES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMBRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-465-5876
Mailing Address - Street 1:829 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4015
Mailing Address - Country:US
Mailing Address - Phone:510-465-5876
Mailing Address - Fax:510-238-5164
Practice Address - Street 1:829 BROADWAY
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4015
Practice Address - Country:US
Practice Address - Phone:510-465-5876
Practice Address - Fax:510-238-5164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD6961332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier