| NPI | 1093957888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY OJEDA Billing Department 909-986-0918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 6807) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 6806) |
| 152W00000X Optometrist (Licence: CA 12804) | |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2010-08-18 |