Provider Demographics
NPI:1912115759
Name:ALLIED OPTICAL
Entity Type:Organization
Organization Name:ALLIED OPTICAL
Other - Org Name:STERLING OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NOHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAKIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-752-5636
Mailing Address - Street 1:3601 JAMBOREE RD
Mailing Address - Street 2:# 15 A
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2961
Mailing Address - Country:US
Mailing Address - Phone:949-752-5636
Mailing Address - Fax:949-752-5925
Practice Address - Street 1:3601 JAMBOREE RD
Practice Address - Street 2:# 15 A
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2961
Practice Address - Country:US
Practice Address - Phone:949-752-5636
Practice Address - Fax:949-752-5925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33600005152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty