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Organization
PACIFIC VISION SURGERY CENTER LLC
Active
Organization
PACIFIC VISION SURGERY CENTER LLC
Active
Other names
Pacific Vision Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY BRYAN (PROGRAM MANAGER)
(415) 420-3934
Entity
Organization
Contact information
Practice address
711 VAN NESS AVE STE 230, SAN FRANCISCO, CA 94102-3271
(415) 997-6410
(415) 727-3851
Mailing address
711 VAN NESS AVE STE 230, SAN FRANCISCO, CA 94102-3271
(415) 997-6410
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
NULL
207W00000X
Ophthalmology Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
05/29/2019
Last updated
05/27/2021
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