Organization
EYESMITH, A PROFESSIONAL OPTOMETRY CORPORATION
Active
Parent organization
EYESMITH, A PROFESSIONAL OPTOMETRY CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
EYESMITH, A PROFESSIONAL OPTOMETRY CORPORATION
Authorized official
DR. THANH NGUYEN O.D. (CHIEF EXECUTIVE OFFICER)
(619) 600-1161
Entity
Organization
Contact information
Practice address
4029 43RD ST STE 300, SAN DIEGO, CA 92105-8537
(619) 284-3937
(619) 284-3938
Mailing address
10956 PORTOBELO DR, SAN DIEGO, CA 92124-1181
(858) 610-8488
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992813323
—
CA
Enumeration date
03/22/2024
Last updated
03/22/2024
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