| NPI | 1558739078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELICA MARIE VILLA CEO 858-260-9208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 10561 T) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: CA 10561 T) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2016-04-17 |