Provider Demographics
NPI:1902914468
Name:HARANO AND HAW OPTOMETRIC CORPORATION
Entity Type:Organization
Organization Name:HARANO AND HAW OPTOMETRIC CORPORATION
Other - Org Name:ROSEMONT OPTOMETRIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAW
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:510-793-4023
Mailing Address - Street 1:35104 NEWARK BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-1220
Mailing Address - Country:US
Mailing Address - Phone:510-793-4023
Mailing Address - Fax:510-793-6052
Practice Address - Street 1:35104 NEWARK BLVD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-1220
Practice Address - Country:US
Practice Address - Phone:510-793-4023
Practice Address - Fax:510-793-6052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-26
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5871152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0058711Medicaid
CAZZZ25072ZMedicare UPIN