| NPI | 1730365446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE TURNER Credentialing Manager 949-688-6205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 1176620002) |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2023-05-01 |