Organization
EYE SPY VISION CARE OPTOMETRY, INC
Active
Other names
Eye Spy Vision Care Optometry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TANYA K MAHAPHON O.D. (PRESIDENT)
(707) 253-7111
Entity
Organization
Contact information
Practice address
2291 SOSCOL AVE, SUITE B, NAPA, CA 94558-3620
(707) 253-7111
(707) 253-7192
Mailing address
2291 SOSCOL AVE, NAPA, CA 94558-3620
(707) 253-7111
(707) 253-7192
Taxonomy
Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
OPT 12138 TPA
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003918012
NPI INDIVIDUAL DOCTOR
CA
Enumeration date
11/28/2006
Last updated
01/25/2013
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