| NPI | 1740777853 |
|---|---|
| Doing Business As | OPTICA -MGM |
| Entity Type | Organization |
| Authorized Contact | NICHOLAS SHASHATI Director 858-414-3513 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 156FX1100X Technician/Technologist Ophthalmic |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2018-04-16 |