PV Vision

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

PV VISION

Practice address

4250 Van Buren Blvd
Riverside, CA 92503-2602

Phone

(213) 500-8292

NPI assigned

Jul 30, 2019

Organization subpart

No

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

Authorized official

Name

Dong Eok Shin

Title

President

Phone

(213) 500-8292

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dream Vision Doing business as

Locations

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

{
    "created_epoch": "1564444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670457600000",
    "number": "1831743525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23684 GOLD NUGGET AVE",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917652335",
            "telephone_number": "213-500-8292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 VAN BUREN BLVD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925032602",
            "telephone_number": "213-500-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PV VISION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-30",
        "last_updated": "2022-12-08",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "DONG EOK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-500-8292"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RDO",
            "identifier": "70820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dream Vision",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dream Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optician in Riverside, CA
• Providers in Riverside, CA by specialty
• Optician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.