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Organization

KK0719 LLC

Active
Other names
California Optical Lab, Anytime Glasses, John Ruvin, Eyeveterans, The Optic Lab, Sportifeye Optics
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY KIM (CEO)
(213) 272-4436
Entity
Organization

Contact information

Practice address
1854 BUSINESS CENTER DR, DUARTE, CA 91010-2901
(626) 521-5600
Mailing address
1854 BUSINESS CENTER DR, DUARTE, CA 91010-2901
(626) 521-5600

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
207W00000X
Ophthalmology Physician
Primary

Other

Enumeration date
02/05/2025
Last updated
02/18/2025
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