Organization
PV VISION
Active
Other names
Dream Vision
Organization subpart
No
Provider details
NPI number
Authorized official
DONG EOK SHIN (PRESIDENT)
(213) 500-8292
Entity
Organization
Contact information
Practice address
4250 VAN BUREN BLVD, RIVERSIDE, CA 92503-2602
(213) 500-8292
Mailing address
23684 GOLD NUGGET AVE, DIAMOND BAR, CA 91765-2335
(213) 500-8292
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70820
RDO
CA
Enumeration date
07/30/2019
Last updated
12/08/2022
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