| NPI | 1598850893 |
|---|---|
| Former Legal Business Name | IRWIN H. MINTZ, OD, INC. |
| Entity Type | Organization |
| Authorized Contact | DENA M. MINTZ President 909-985-2876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT8810TPA) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 4109T) |
| 152W00000X Optometrist (Licence: CA 5933T) | |
| 152W00000X Optometrist (Licence: CA 8810T) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2010-09-24 |