Provider Demographics
NPI:1043027626
Name:JASON HA OPTOMETRIC PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:JASON HA OPTOMETRIC PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:HA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:682-556-0583
Mailing Address - Street 1:10246 STOCKMEN WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-3535
Mailing Address - Country:US
Mailing Address - Phone:682-556-0583
Mailing Address - Fax:
Practice Address - Street 1:6320 MACK RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-4646
Practice Address - Country:US
Practice Address - Phone:682-556-0583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty