Organization
SACKS OPTICAL BOUTIQUE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT DAVID SACKS M.D. (PRESIDENT)
(310) 275-1676
Entity
Organization
Contact information
Practice address
1125 S BEVERLY DR, 710, LOS ANGELES, CA 90035-1148
(310) 275-1676
Mailing address
1125 S BEVERLY DR, 710, LOS ANGELES, CA 90035-1148
(310) 275-1676
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
G64460
CA
Other
Enumeration date
11/11/2009
Last updated
09/22/2010
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