| NPI | 1457681371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL J SUPER Optometrist 310-820-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OP8867TPG) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: CA OPT8867T) |
| 152WV0400X Optometrist, Vision Therapy (Licence: CA OP8867TPG) | |
| 152WP0200X Optometrist, Pediatrics (Licence: CA OP8867TPG) | |
| 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: CA OP8867TPG) | |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: CA OP8867TPG) | |
| Enumeration Date | 2009-12-29 |
| Last Update Date | 2016-03-03 |