Provider Demographics
NPI:1962754481
Name:ISEE OPTOMETRY
Entity type:Organization
Organization Name:ISEE OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:VOTRAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:408-960-6479
Mailing Address - Street 1:334 SANTANA ROW APT 342
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2026
Mailing Address - Country:US
Mailing Address - Phone:408-960-6479
Mailing Address - Fax:408-912-5843
Practice Address - Street 1:3151 SENTER RD
Practice Address - Street 2:SUITE 130
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95111-1370
Practice Address - Country:US
Practice Address - Phone:408-960-6479
Practice Address - Fax:408-912-5843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 14241152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFU220AMedicare PIN