| NPI | 1164567004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA ORDUNEZ Business Office Manager 818-845-3557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA G034555) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA OPT5501TPA) |
| 152W00000X Optometrist (Licence: CA OPT12823TPA) | |
| 152W00000X Optometrist (Licence: CA OPT12974TPA) | |
| 152W00000X Optometrist (Licence: CA OPT12879TPA) | |
| 207W00000X Ophthalmology (Licence: CA G48218) | |
| 207W00000X Ophthalmology (Licence: CA A79304) | |
| 207W00000X Ophthalmology (Licence: CA A75480) | |
| 207W00000X Ophthalmology (Licence: CA G64713) | |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2022-04-12 |