Organization
EYE SPY VISION CARE OPTOMETRY, INC
Active
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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