| NPI | 1912184359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER SHAW- MCMINN Owner/Optometrist 951-780-0270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA opt6553t) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2008-01-29 |