| NPI | 1487807368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA D SULLIVAN Practice Administrator 310-208-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2015-03-19 |