Organization · Type 2 NPI

Costco Wholesale Corporation

Eyewear Supplier · La Habra, CA

NPI number 1790174647 Active

Practice location

101 N Beach Blvd
La Habra, CA 90631-4468

Call (562) 524-0004 Map

Fax (562) 524-0023

Mailing address

PO Box 35005
Seattle, WA 98124-3405

Specialties and licenses

Taxonomy	Code	License
Eyewear Supplier Primary	332H00000X	D7127 (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 La Habra

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NPI record

NPI: 1790174647
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 #777 · doing business as
Costco Optical #777 · doing business as

Authorized official

Art Salas
AVP Optical
(562) 524-0004

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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 1790174647

Costco Wholesale Corporation's National Provider Identifier is 1790174647, issued on Jan 15, 2015. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in La Habra, CA. The record was last updated on Jun 11, 2020.