MID-PENINSULA OPTICAL; NPI #1073649273

Contact Information

MID-PENINSULA OPTICAL

883 SANTA CRUZ AVE
MENLO PARK, CA 94025-4638

Phone: 650-324-4333
Fax: 650-324-4311
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Optician	156FX1800X	96[5]	Optician
Contact Lens Fitter	156FC0801X

Indicates primary specialty

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NPI Profile & details for MID-PENINSULA OPTICAL

NPI # 1073649273

LBN Legal business name MID-PENINSULA OPTICAL

Authorized official DANIEL PAQUETTE - (OWNER OPTICIAN)

Entity Organization

Organization subpart ¹ No

Enumeration date 02/24/2007

Last updated 09/11/2025 - About 9 months ago

Identifiers

CA	License #	CL391
CA	License #	SL0611
CA	Other	CA0391	EYEMEDVISIONCARE

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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MID-PENINSULA OPTICAL

Contact Information

Specialty

Optician

Contact Lens Fitter

NPI Profile & details for MID-PENINSULA OPTICAL

Reviews for MID-PENINSULA OPTICAL