Organization
PACIFIC VISION SURGERY CENTER LLC
Active
Other names
Pacific Vision Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY BRYAN (PROGRAM MANAGER)
(415) 420-3934
Entity
Organization
Contact information
Practice address
711 VAN NESS AVE STE 230, SAN FRANCISCO, CA 94102-3271
(415) 997-6410
(415) 727-3851
Mailing address
711 VAN NESS AVE STE 230, SAN FRANCISCO, CA 94102-3271
(415) 997-6410
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1503942
—
CA
Enumeration date
05/29/2019
Last updated
05/27/2021
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