Organization · Type 2 NPI

Costco Wholesale Corporation

Eyewear Supplier · San Diego, CA

NPI number 1295125334 Active

Practice location

12350 Carmel Mountain Rd
San Diego, CA 92128-4616

Call (858) 675-0619 Map

Fax (858) 675-0876

Mailing address

PO Box 35005
Seattle, WA 98124-3405

Specialties and licenses

Taxonomy	Code	License
Eyewear Supplier Primary	332H00000X	D6836 (CA)

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

9 other providers at this address

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NPI record

NPI: 1295125334
Entity type: Organization (Type 2)
Issued: Jan 28, 2015
Last updated: Jun 5, 2020
Status: Active
Subpart: Yes of Costco Wholesale Corporation

Other names

<unavail>
Costco Optical #452 · doing business as
Costco Optical #452 · doing business as

Authorized official

Art Salas
AVP Optical
(858) 675-0619

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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 1295125334

Costco Wholesale Corporation's National Provider Identifier is 1295125334, issued on Jan 28, 2015. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in San Diego, CA. The record was last updated on Jun 5, 2020.