Organization
SPECTRUM EYE PHYSICIANS, A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOEL WILHELM COE (ADMINISTRATOR/CONTROLLER)
(408) 252-7310
Entity
Organization
Contact information
Practice address
10300 S DE ANZA BLVD, SUITE A, CUPERTINO, CA 95014-3030
(408) 253-3083
(408) 253-2965
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 13831 TLG
CA
207W00000X
Ophthalmology Physician
Primary
—
CA
332H00000X
Eyewear Supplier
SRYGH 97-67584700006
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0103600
—
CA
05
—
GR0103601
—
CA
05
—
GR0103602
—
CA
05
—
GR0103603
—
CA
Enumeration date
05/27/2006
Last updated
02/02/2016
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