Provider Demographics
NPI:1598658478
Name:SM OPTICAL INC
Entity type:Organization
Organization Name:SM OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SOBHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SERGIOUS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:510-300-7944
Mailing Address - Street 1:528 BURLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-4921
Mailing Address - Country:US
Mailing Address - Phone:510-300-7944
Mailing Address - Fax:
Practice Address - Street 1:730 CAMINO RAMON STE 170
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-4263
Practice Address - Country:US
Practice Address - Phone:925-964-1010
Practice Address - Fax:925-964-1011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty