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Costco Wholesale Corporation — NPI 1174912646, San Bernardino, CA | NPI Central

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NPI 1174912646

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Costco Wholesale Corporation

NPI 1174912646 · Eyewear Supplier · San Bernardino, CA

Provider details

NPI number: 1174912646
Entity type: Organization
Primary specialty: Eyewear SupplierSuppliers
Parent organization: Costco Wholesale Corporation
Organization subpart: Yes
Authorized official: Art Salas, Avp Optical(909) 478-3445
License: D4126 (CA)

Specialties & taxonomies

Eyewear SupplierPrimary332H00000XLicense D4126 (CA)
Suppliers

Practice location

1099 E Hospitality Ln

San Bernardino, CA 92408-2813

Phone: (909) 478-3445

Approximate (ZIP-level) locationGet directions

More CA providers

Mailing address

Po Box 35005

Seattle, WA 98124-3405

Other names (DBA / former)

Doing business as: Costco Optical #478
Doing business as: Costco Optical #478

Registry dates

Enumerated: 2015-01-21
Last updated: 2020-06-12
Certified: 2020-06-12

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.