Provider Demographics
NPI:1679899413
Name:V LIANE RICE OD A PROFESSIONAL CORP
Entity type:Organization
Organization Name:V LIANE RICE OD A PROFESSIONAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:LIANE
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:408-377-1150
Mailing Address - Street 1:2730 UNION AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-1431
Mailing Address - Country:US
Mailing Address - Phone:408-377-1150
Mailing Address - Fax:408-377-1152
Practice Address - Street 1:2730 UNION AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-1431
Practice Address - Country:US
Practice Address - Phone:408-377-1150
Practice Address - Fax:408-377-1152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-19
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7913TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACY241AMedicare PIN
T10618Medicare UPIN