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Organization
OAKLAND VISION CENTER
Active
Organization
OAKLAND VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL A GRONDONA O.D. (PRESIDENT)
(510) 893-5566
Entity
Organization
Contact information
Practice address
1960 BROADWAY, OAKLAND, CA 94612-2206
(510) 893-5566
(510) 893-3921
Mailing address
1960 BROADWAY, OAKLAND, CA 94612-2206
(510) 893-5566
(510) 893-3921
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
COR 158
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GSD000070
—
CA
Enumeration date
08/30/2006
Last updated
08/22/2020
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