Provider Demographics
NPI:1932179801
Name:RICE, VIVIAN LIANE (OD)
Entity Type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:LIANE
Last Name:RICE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-1431
Mailing Address - Country:US
Mailing Address - Phone:408-377-1150
Mailing Address - Fax:408-377-1152
Practice Address - Street 1:2730 UNION AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-1431
Practice Address - Country:US
Practice Address - Phone:408-377-1150
Practice Address - Fax:408-377-1152
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7913T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0079130Medicare PIN