Provider Demographics
NPI:1316135759
Name:HEALTHY EYES OPTOMETRY INC
Entity type:Organization
Organization Name:HEALTHY EYES OPTOMETRY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:JING
Authorized Official - Middle Name:
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:916-983-6838
Mailing Address - Street 1:2690 E BIDWELL ST
Mailing Address - Street 2:STE 500
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-6430
Mailing Address - Country:US
Mailing Address - Phone:916-983-6838
Mailing Address - Fax:916-983-6846
Practice Address - Street 1:2690 E BIDWELL ST
Practice Address - Street 2:STE 500
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-6430
Practice Address - Country:US
Practice Address - Phone:916-983-6838
Practice Address - Fax:916-983-6846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12733152WC0802X, 152WP0200X, 152WX0102X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
No152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Multi-Specialty