| NPI | 1487793667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG K WOODWORTH Optometrist Owner 619-447-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 7606TPA) |
| Additional Taxonomies | 156FC0800X Technician/Technologist, Contact Lens (Licence: CA 7606TPA) |
| 156FC0801X Technician/Technologist, Contact Lens Fitter (Licence: CA 7606TPA) | |
| 156FX1800X Technician/Technologist, Optician (Licence: CA 7606TPA) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2008-06-02 |