NPIMap

Organization Active NPI

Exotique Vision

  • Optician
  • Cupertino, CA
National Provider Identifier
1063530863
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
24791543 Issued in CA
Legal business name
EXOTIQUE VISION
Practice address
10123 N Wolfe Rd
2009
Cupertino, CA 95014-2509
Phone
(408) 255-8100
Fax
(408) 255-5831
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rima Hanna Abboud
Title
President
Phone
(408) 255-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X 24791543 CA Primary

Addresses

Primary practice location

10123 N Wolfe Rd
2009
Cupertino, CA 95014-2509

Mailing address

10123 N Wolfe Rd
2009
Cupertino, CA 95014-2509
Phone (408) 255-8100

Other names 1

  • Site For Sore Eyes Doing business as

National Provider Directory

National Provider Directory

Locations

10123 N Wolfe Rd
Ste 2009
Cupertino, CA 95014
Phone (408) 255-8100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063530863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10123 N WOLFE RD",
            "address_2": "2009",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142509",
            "telephone_number": "408-255-8100",
            "fax_number": "408-255-5831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10123 N WOLFE RD",
            "address_2": "2009",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142509",
            "telephone_number": "408-255-8100",
            "fax_number": "408-255-5831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXOTIQUE VISION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ABBOUD",
        "authorized_official_first_name": "RIMA",
        "authorized_official_middle_name": "HANNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-255-8100"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "CA",
            "license": "24791543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Site For Sore Eyes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cupertino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.