Organization · Type 2 NPI

Costco Wholesale Corporation

Eyewear Supplier · Tustin, CA

NPI number 1154710002 Active

Practice location

2655 El Camino Real
Tustin, CA 92782-8918

Call (714) 838-0498 Map

Fax (714) 838-7082

Mailing address

PO Box 35005
Seattle, WA 98124-3405

Specialties and licenses

Taxonomy	Code	License
Eyewear Supplier Primary	332H00000X	D5895 (CA)

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

10 other providers at this address

Other eyewear supplier providers in Tustin

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NPI record

NPI: 1154710002
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 #122 · doing business as
Costco Optical #122 · doing business as

Authorized official

Art Salas
AVP Optical
(714) 838-0498

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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 1154710002

Costco Wholesale Corporation's National Provider Identifier is 1154710002, issued on Jan 15, 2015. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Tustin, CA. The record was last updated on Jun 11, 2020.