Basic Information
| Provider Information | |||||||||
| NPI: | 1407065832 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SEE CLEARLY VISION GROUP, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8138 WATSON ST | ||||||||
| Address2: | |||||||||
| City: | MC LEAN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221024416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038275454 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8138 WATSON ST | ||||||||
| Address2: | |||||||||
| City: | MC LEAN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221024416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038275454 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2007 | ||||||||
| LastUpdateDate: | 09/07/2011 | ||||||||
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| AuthorizedOfficialLastName: | RAJPAL | ||||||||
| AuthorizedOfficialFirstName: | RAJESH | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7038275454 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152WC0802X | 0618001062 | VA | Y | 193200000X MULTI-SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist | Corneal and Contact Management |
No ID Information.