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Organization

MID-PENINSULA OPTICAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANIEL PAQUETTE (OWNER OPTICIAN)
(650) 324-4333
Entity
Organization

Contact information

Practice address
883 SANTA CRUZ AVE, MENLO PARK, CA 94025-4638
(650) 324-4333
(650) 324-4311
Mailing address
883 SANTA CRUZ AVE, MENLO PARK, CA 94025-4638
(650) 324-4333
(650) 324-4311

Taxonomy

Speciality
Code
Description
License number
State
156FC0801X
Contact Lens Fitter
CL391
CA
156FX1800X
Optician
Primary
SL0611
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CA0391
EYEMEDVISIONCARE
CA
Enumeration date
02/24/2007
Last updated
09/11/2025
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