Provider Demographics
NPI:1790505188
Name:MOUNTAIN VIEW EYECARE LLC
Entity type:Organization
Organization Name:MOUNTAIN VIEW EYECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:MAX
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:720-419-9923
Mailing Address - Street 1:14307 DOUBLE DUTCH CIR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-8909
Mailing Address - Country:US
Mailing Address - Phone:720-419-9923
Mailing Address - Fax:
Practice Address - Street 1:10900 E BRIARWOOD AVE
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3820
Practice Address - Country:US
Practice Address - Phone:303-706-9833
Practice Address - Fax:303-706-9838
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOUNTAIN VIEW EYECARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-11
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty