Organization
EYE KLINIC INC
Active
Other names
eyeklinic of edinburgh
Organization subpart
No
Provider details
NPI number
Authorized official
JOSAN W. T. KO (CEO)
(763) 315-0909
Entity
Organization
Contact information
Practice address
4620 OAK GROVE PKWY N, BROOKLYN PARK, MN 55443-4062
(763) 315-0909
Mailing address
4620 OAK GROVE PKWY N, BROOKLYN PARK, MN 55443-4062
(763) 315-0909
(763) 315-0203
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
MN2869
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
181414
UCARE MINNESOTA
MN
01
—
191361040082
PREFERRED ONE
MN
01
—
19981
NVA
MN
01
—
21-00588
MEDICA
MN
01
—
26833
SPECTERA
MN
01
—
35135
AVESIS
MN
05
—
822081600
—
MN
01
—
9529921700
PATIENT CHOICE
MN
01
—
958S7EY
BCBSM
MN
01
—
J52607
DAVIS VSION
MN
01
—
MN02869
VBA
MN
Enumeration date
11/30/2006
Last updated
03/29/2023
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