Basic Information
| Provider Information | |||||||||
| NPI: | 1215508544 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BEYOND VISION CENTER INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3525 DEL MAR HEIGHTS RD # 1953 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921302199 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046773776 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6949 EL CAMINO REAL STE 105 | ||||||||
| Address2: | |||||||||
| City: | CARLSBAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920094140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046773776 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2021 | ||||||||
| LastUpdateDate: | 01/14/2022 | ||||||||
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| AuthorizedOfficialLastName: | MORGAN | ||||||||
| AuthorizedOfficialFirstName: | HUNTER | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/OD | ||||||||
| AuthorizedOfficialTelephone: | 3046773776 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | OD | ||||||||
| NPICertificationDate: | 01/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.