Provider Demographics
NPI:1962990432
Name:PACIFIC VISION EYE INSTITUTE, A MEDICAL CORPORATION
Entity type:Organization
Organization Name:PACIFIC VISION EYE INSTITUTE, A MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-567-8200
Mailing Address - Street 1:711 VAN NESS AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-3272
Mailing Address - Country:US
Mailing Address - Phone:415-393-1225
Mailing Address - Fax:
Practice Address - Street 1:711 VAN NESS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3244
Practice Address - Country:US
Practice Address - Phone:415-393-1225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-30
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty