| NPI | 1023094570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC E GAYLORD Owner 323-294-7517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA COR 889) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: CA COR 889) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2018-06-16 |