Provider Demographics
NPI:1730537143
Name:Y GREGG HIGUCHI OD A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:Y GREGG HIGUCHI OD A PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YUKIO
Authorized Official - Middle Name:GREGG
Authorized Official - Last Name:HIGUCHI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:415-431-2988
Mailing Address - Street 1:586 CASTRO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-2512
Mailing Address - Country:US
Mailing Address - Phone:415-431-2988
Mailing Address - Fax:415-431-2908
Practice Address - Street 1:586 CASTRO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-2512
Practice Address - Country:US
Practice Address - Phone:415-431-2988
Practice Address - Fax:415-431-2908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-25
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9261T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty