Provider Demographics
NPI:1063997005
Name:VINCENT CANO, OD, A PROF CORP
Entity type:Organization
Organization Name:VINCENT CANO, OD, A PROF CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:CANO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:559-859-8856
Mailing Address - Street 1:111 STEPPING STONE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92603-0676
Mailing Address - Country:US
Mailing Address - Phone:559-859-8856
Mailing Address - Fax:
Practice Address - Street 1:25800 JERONIMO RD STE 701
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-7918
Practice Address - Country:US
Practice Address - Phone:559-859-8856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty