Provider Demographics
NPI:1194291294
Name:POOLSAAD FAMILY VISION OPTOMETRY INC
Entity type:Organization
Organization Name:POOLSAAD FAMILY VISION OPTOMETRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:609-351-4395
Mailing Address - Street 1:4700 N LAKEWOOD BLVD APT 6
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1066
Mailing Address - Country:US
Mailing Address - Phone:609-351-4395
Mailing Address - Fax:
Practice Address - Street 1:8135 PAINTER AVE STE 100
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-3159
Practice Address - Country:US
Practice Address - Phone:609-351-4395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty