Provider Demographics
NPI:1730503293
Name:JC OPTICS LLC
Entity type:Organization
Organization Name:JC OPTICS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HANI
Authorized Official - Middle Name:
Authorized Official - Last Name:ELMANKABADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-963-6945
Mailing Address - Street 1:4540 DUBLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-7564
Mailing Address - Country:US
Mailing Address - Phone:925-833-3937
Mailing Address - Fax:925-833-3985
Practice Address - Street 1:4540 DUBLIN BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-7564
Practice Address - Country:US
Practice Address - Phone:925-833-3937
Practice Address - Fax:925-833-3985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD7560332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FAC 69724OtherSAFE GUARD VISION
CAA04090OtherEYEMED
64691OtherSPECTERA
830998OtherNATIONAL VISION ADMINISTRATION
CA8499OtherVISION SERVICE PLAN,
03437SOtherDAVIS VISION
9258333937OtherMARCH VISION