Organization
SPECTRUM EYE PHYSICIANS, A MEDICAL CORPORATION
Active
Other names
Spectrum Eye Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J. WILHELM C.O.E. (ADMINISTRATOR/CONTROLLER)
(408) 252-7310
Entity
Organization
Contact information
Practice address
431 MONTEREY AVE, SUITE 3, LOS GATOS, CA 95030-5319
(408) 354-9510
(408) 395-1610
Mailing address
10300 S DE ANZA BLVD, SUITE A, CUPERTINO, CA 95014-3030
(408) 253-3083
(408) 253-2965
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPT 13829 TLG
CA
207W00000X
Ophthalmology Physician
A69913
CA
207W00000X
Ophthalmology Physician
G26839
CA
332H00000X
Eyewear Supplier
Primary
97-675847 00002 GH
CA
Other
Enumeration date
09/25/2012
Last updated
09/25/2012
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