Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Optician |
156FX1800X | 96[5] | Optician | |
Contact Lens |
156FC0800X | |||
Optometric Technician |
156FX1202X | |||
Optometrist |
152W00000X | 41 | Optometry |
| NPI # | 1134827199 |
| LBN Legal business name | BEACON EYE CARE CENTER |
| Authorized official | JOSUE ROJA - (PRESIDENT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 02/20/2023 |
| Last updated | 02/20/2023 - About 3 years ago |
| Identifiers | n/a |
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