Provider Demographics
NPI:1104921410
Name:UNION VISION SERVICES
Entity type:Organization
Organization Name:UNION VISION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:650-315-5468
Mailing Address - Street 1:1420 HAMPSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4818
Mailing Address - Country:US
Mailing Address - Phone:650-315-5468
Mailing Address - Fax:415-285-7057
Practice Address - Street 1:1765 CHALLENGE WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-5097
Practice Address - Country:US
Practice Address - Phone:916-567-0888
Practice Address - Fax:916-567-0969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5798T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGS001950Medicaid
CAZZZ15081ZMedicare ID - Type UnspecifiedGROUP PROVIDER NUMBER