Organization · NPI-2

Glaze Optical, INC

Technician/Technologist, Optician · San Diego, CA

NPI number1184212946
StatusActive
Last updated in NPPESJan 7, 2021

Details

NPI
1184212946
Entity type
Organization (NPI-2)
Legal business name
Glaze Optical, INC
Organization subpart
No
Enumeration date
Jan 7, 2021
Certification date
Jan 7, 2021
Last updated
Jan 7, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156FX1800X Technician/Technologist, Optician––Yes

Practice location

2275 Michael Faraday Dr Ste 4
San Diego, CA 92154-7927

Phone 805-630-7375

Mailing address

186 E Radcliffe Dr
Claremont, CA 91711-2832

Phone 805-630-7375

Authorized official

Tony Mario Esposito
Ceo
8056307375

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