# GAGNON VISION MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588091367
- **Authorized official:** MRS. LORI GAGNON M.A. (CEO)
- **Authorized official phone:** (925) 822-8776

## Contact information

- **Practice address:** 28 FENTON ST, LIVERMORE, CA 94550-4144
- **Practice address phone:** (925) 449-4000
- **Mailing address:** 5575 W LAS POSITAS BLVD, SUITE 240, PLEASANTON, CA 94588-5801
- **Mailing address phone:** (925) 460-5000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 332H00000X | Eyewear Supplier | — | NULL | — |

## Other

- **Enumeration date:** 10/11/2013
- **Last updated:** 10/11/2013