Provider Demographics
NPI:1366082398
Name:PERSONALEYES, INC
Entity type:Organization
Organization Name:PERSONALEYES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELDON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:541-548-2488
Mailing Address - Street 1:1000 SW INDIAN AVE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-3039
Mailing Address - Country:US
Mailing Address - Phone:541-548-2488
Mailing Address - Fax:541-548-5334
Practice Address - Street 1:212 BON AIR CTR
Practice Address - Street 2:
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2416
Practice Address - Country:US
Practice Address - Phone:415-461-9222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty