Provider Demographics
NPI:1932378296
Name:SZETO OPTOMETRIC CORPORATION
Entity Type:Organization
Organization Name:SZETO OPTOMETRIC CORPORATION
Other - Org Name:CLEARVUE OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:TONGDONG
Authorized Official - Last Name:SZETO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:626-287-2020
Mailing Address - Street 1:937 E LAS TUNAS DR STE A
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1600
Mailing Address - Country:US
Mailing Address - Phone:626-287-2020
Mailing Address - Fax:626-287-0257
Practice Address - Street 1:937 E LAS TUNAS DR STE A
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1600
Practice Address - Country:US
Practice Address - Phone:626-287-2020
Practice Address - Fax:626-287-0257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W15963Medicare PIN