| NPI | 1144369372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY MCMAINS President 619-229-9767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist Corneal and Contact Management (Licence: CA 11525T) |
| Additional Taxonomies | 152WP0200X Optometrist Pediatrics (Licence: CA 11525T) |
| 152WS0006X Optometrist Sports Vision (Licence: CA 11525T) | |
| 152WV0400X Optometrist Vision Therapy (Licence: CA 11525T) | |
| 152WX0102X Optometrist Occupational Vision (Licence: CA 11525T) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-08-22 |