OrganizationActive
Costco Wholesale Corporation
NPI 1376932848 · Eyewear Supplier · Azusa, CA
Provider details
- NPI number
- 1376932848
- Entity type
- Organization
- Primary specialty
- Eyewear SupplierSuppliers
- Parent organization
- Costco Wholesale Corporation
- Organization subpart
- Yes
- Authorized official
- Art Salas, Avp Optical(626) 812-7925
- License
- D6823 (CA)
Specialties & taxonomies
Suppliers
Profile Score
Established profile(74/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1220 W Foothill Blvd
Azusa, CA 91702-2819
Phone: (626) 812-7925
Fax: (626) 812-7920
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 35005
Seattle, WA 98124-3405
Other names (DBA / former)
- Doing business as
- Costco Optical #412
- Doing business as
- Costco Optical #412
Registry dates
- Enumerated
- 2015-01-21
- Last updated
- 2020-06-11
- Certified
- 2020-06-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.