EXPRESS LENS LAB, INC. (NPI# 1164588133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164588133 |
| Entity Type | Organization |
| Organization Name | EXPRESS LENS LAB, INC. |
| Practice Address |
17150 Newhope St Suite 305 Fountain Valley CA 92708-4250 |
| Practice Telephone | 7145451024 |
| Practice Fax Number | 7145562026 |
| Mailing Telephone | 7145451024 |
| Mailing Fax Number | 7145562026 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. BRIAN KEITH GOLDSTONE (PRESIDENT) |
| Authorized Official Telephone | 7145451024 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | 19209 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 88272567 | 05 | |
| AZ | 772534 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | EXPRESS LENS LAB, INC. | 17150 Newhope St 305, Fountain Valley, CA 92708-4251 |
| Street Address |
17150 NEWHOPE ST SUITE 305 |
| City | FOUNTAIN VALLEY |
| State | CA |
| Zip Code | 92708-4250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235134263 | Kamini Malhotra | Pathology | 17150 Newhope St, Ste 117, Fountain Valley, CA 92708-4273 | 2005-06-16 |
| 1720230733 | Loc H Nguyen Md Inc | Anesthesiology | 17150 Newhope St, Fountain Valley, CA 92708-4250 | 2008-10-21 |
| 1023150182 | Kamini Malhotra, M.d Inc | Pathology | 17150 Newhope St, Suite 117, Fountain Valley, CA 92708-4273 | 2007-02-13 |
| 1679575757 | Sheldon Barasch | Pathology | 17150 Newhope St, Ste 117, Fountain Valley, CA 92708-4273 | 2005-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932716222 | Changing Directions Psychological Corporation | Psychologist | 17280 Newhope Street, Suite 4, Fountain Valley, CA 92708 | 2020-09-30 |
| 1124632757 | Neck & Back Pain Specialists, A Balta Chiropractic Corporation | Chiropractor | 10231 Slater Ave. #113, Fountain Valley, CA 92708 | 2020-09-01 |
| 1295205425 | Alexander Nee Dds Inc | Dentist | 337 S Rancho Santa Fe Rd, San Marcos, CA 92708 | 2018-11-30 |
| 1093293052 | Claudia Raquel Santos | Physical Therapist | 18384 Brookhurst Street, Fountain Valley, CA 92708 | 2018-08-01 |
| 1659864338 | Orange County Respiratory Physicians Corp | Internal Medicine | 18111 Brookhurst St Ste 4600, Fountain Valley, CA 92708 | 2018-06-07 |
| 1992297881 | Ereny Abdelmalak Metry | Pharmacist | 9064 Daffodil Ave, Fountain Valley, CA 92708 | 2018-06-06 |
| 1144746348 | Goose Pharma, LLC | Pharmacy | 18049 Magnolia Street, Fountain Valley, CA 92708 | 2017-08-18 |
| 1932622347 | Mayra Alejandra Guerra | Social Worker | 18350 Mt Langley St, Suite 200, Fountain Valley, CA 92708 | 2017-07-18 |
| 1942722129 | Graph Surgery Inc | Plastic Surgery | 10760 Warner Ave, Ste 201, Fountain Valley, CA 92708 | 2017-07-10 |
| 1871022277 | Cathy A Castagna-petersen | Counselor | 10529 Slater Avenue, Fountain Valley, CA 92708 | 2017-06-08 |
| Find all providers in zip 92708 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063801918 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 17900 Newhope St, Fountain Valley, CA 92708-5422 | 2015-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902488 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 300 E Colorado Blvd Ste 128, Pasadena, CA 91101-2267 | 2020-11-02 |
| 1700485562 | Vision Faire Optometry, Inc. A Professional Optometric Corporation | Eyewear Supplier (Equipment, not the service) | 4213 Dale Rd Ste A-2, Modesto, CA 95356-8505 | 2020-10-22 |
| 1154929859 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 5500 W Sunset Blvd, Los Angeles, CA 90028 | 2020-10-14 |
| 1295333029 | Tiger & Lion Inc | Eyewear Supplier (Equipment, not the service) | 1251 S Beach Blvd Ste F, La Habra, CA 90631-6397 | 2020-10-14 |
| 1245866565 | Joshua Adolfo Velasquez | Eyewear Supplier (Equipment, not the service) | 849 N Ridgewood Pl, Los Angeles, CA 90038-4302 | 2020-03-18 |
| 1952948424 | Luvc LLC | Eyewear Supplier (Equipment, not the service) | 2223 Carlton Ave, Pomona, CA 91768-1015 | 2019-12-04 |
| 1568011377 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 6440 E. Pacific Coast Highway, Space B-165, Long Beach, CA 90803 | 2019-09-05 |
| 1184270746 | Nueyes Technologies Inc | Eyewear Supplier (Equipment, not the service) | 120 Newport Center Dr # 232, Newport Beach, CA 92660-6916 | 2019-08-09 |
| 1881248102 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 12182 1/2 Ventura Blvd, Studio City, CA 91604-2517 | 2019-07-25 |
| 1730732363 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 1628 Redwood Hwy Spc D017, Corte Madera, CA 94925-1248 | 2019-07-23 |
| Find all providers with the same taxonomy | ||||
| City | FOUNTAIN VALLEY |
| Zip Code | 92708 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.