Organization · Type 2 NPI

Costco Wholesale Corporation

Eyewear Supplier · Marina Del Rey, CA

NPI number 1053700906 Active

Practice location

13463 Washington Blvd
Marina Del Rey, CA 90292-5658

Call (310) 754-2001 Map

Fax (310) 754-2005

Mailing address

PO Box 35005
Seattle, WA 98124-3405

Specialties and licenses

Taxonomy	Code	License
Eyewear Supplier Primary	332H00000X	D6455 (CA)

Eyewear Supplier: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

13 other providers at this address

Other eyewear supplier providers in Marina Del Rey

Warby Parker Inc.Eyewear Supplier Marina Del Rey, CA NPI 1366199168

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NPI record

NPI: 1053700906
Entity type: Organization (Type 2)
Issued: Jan 15, 2015
Last updated: Jun 11, 2020
Status: Active
Subpart: Yes of Costco Wholesale Corporation

Other names

<unavail>
Costco Optical #479 · doing business as
Costco Optical #479 · doing business as

Authorized official

Art Salas
AVP Optical
(310) 754-2001

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1053700906

Costco Wholesale Corporation's National Provider Identifier is 1053700906, issued on Jan 15, 2015. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Marina Del Rey, CA. The record was last updated on Jun 11, 2020.