Provider Demographics
NPI:1154195105
Name:BELLO OPTOMETRIC INC
Entity type:Organization
Organization Name:BELLO OPTOMETRIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUBY
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:773-807-2504
Mailing Address - Street 1:650 GATEWAY CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-4530
Mailing Address - Country:US
Mailing Address - Phone:619-262-2494
Mailing Address - Fax:619-262-2560
Practice Address - Street 1:650 GATEWAY CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92102-4530
Practice Address - Country:US
Practice Address - Phone:619-262-2494
Practice Address - Fax:619-262-2560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty