| NPI | 1063500619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN WATT KURATA Optometrist 310-453-0489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OP7676T) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CA OP7676T) |
| 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: CA OP7676T) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2020-08-22 |