1811174527 NPI number — WHIT-MAR OPTICS INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811174527 NPI number — WHIT-MAR OPTICS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WHIT-MAR OPTICS INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SITE FOR SORE EYES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811174527
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1049 COCHRANE RD SUITE 130
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORGAN HILL
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-778-4633
Provider Business Mailing Address Fax Number:
408-778-1048

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1049 COCHRANE RD
Provider Second Line Business Practice Location Address:
SUITE 130
Provider Business Practice Location Address City Name:
MORGAN HILL
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-778-4633
Provider Business Practice Location Address Fax Number:
408-778-1048
Provider Enumeration Date:
01/24/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WHITE
Authorized Official First Name:
MARYANN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
408-778-4633

Provider Taxonomy Codes

  • Taxonomy code: 156FX1800X , with the licence number:  7328 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)