Organization · NPI-2

Boaz Eyewear Opt,inc

Technician/Technologist, Optician · Los Angeles, CA

NPI number1881330876
StatusActive
Last updated in NPPESMay 11, 2022

Details

NPI
1881330876
Entity type
Organization (NPI-2)
Legal business name
Boaz Eyewear Opt,inc
Organization subpart
No
Enumeration date
May 11, 2022
Certification date
May 7, 2022
Last updated
May 11, 2022

Taxonomy and licenses

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

Practice location

621 S Western Ave Ste 214
Los Angeles, CA 90005-3042

Phone 213-389-1001 · Fax 213-389-1002

Mailing address

621 S Western Ave Ste 214
Los Angeles, CA 90005-3042

Authorized official

Kyu Hwan Jang
Ceo
2133891001

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