National Provider Identifier Database

MID PENINSULA OPTICAL
Optician


Contact Information

MID-PENINSULA OPTICAL
883 SANTA CRUZ AVE
MENLO PARK, CA94025-4638
Phone: 650-324-4333
Fax: 650-324-4311
Website:
Specialty Taxonomy Code
* Optician 156FX1800X
Contact Lens Fitter 156FC0801X

* Indicates primary specialty

NPI Profile & details for MID-PENINSULA OPTICAL

NPI Number 1073649273
Legal business name
LBN
MID-PENINSULA OPTICAL
Authorized official DANIEL PAQUETTE - (OWNER OPTICIAN)
Entity Organization
Organization subpart No
Enumeration date 02/24/2007
Last updated 09/11/2025 - About 9 months ago
Sole proprietor1 Not specified
Identifiers
  • CA License #: CL391
  • CA License #: SL0611
  • CA Other: CA0391 EYEMEDVISIONCARE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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