| NPI | 1902007446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA JEAN VILLA Principal Officer 949-400-1530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT 10245 TPA) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-22 |