| NPI | 1932492402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLE LEWIS Ocularist 310-271-8801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 49641) |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2011-05-17 |