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Organization
VISUAL EDGE OPTOMERTIC GROUP
Active
Organization
VISUAL EDGE OPTOMERTIC GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER E KOVACH O.D. (VICE PRESIDENT)
(408) 842-2020
Entity
Organization
Contact information
Practice address
8050 SANTA TERESA BLVD, SUITE 110, GILROY, CA 95020-3862
(408) 842-2020
(408) 842-0312
Mailing address
8050 SANTA TERESA BLVD, SUITE 110, GILROY, CA 95020-3862
(408) 842-2020
(408) 842-0312
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8766T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225028236
NPI NUMBER
—
05
—
GSD004630
—
CA
05
—
SD0087660
—
CA
Enumeration date
10/21/2005
Last updated
11/10/2011
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