| NPI | 1790053056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL J. SUPER President 310-500-8867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WL0500X Optometrist, Low Vision Rehabilitation |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 152W00000X Optometrist | |
| 225XL0004X Occupational Therapist, Low Vision | |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2011-12-01 |