Bryan D. Vanesian Od A Professional Optometry Corporation | |
4355 Phelan Rd, Phelan, CA 92371-7675 | |
(760) 868-2020 | |
Not Available |
Full Name | Bryan D. Vanesian Od A Professional Optometry Corporation |
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Type | Facility |
Speciality | Optometrist |
Location | 4355 Phelan Rd, Phelan, California |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437312832 | NPI | - | NPPES |
SD0093750 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | 9375T (California) | Primary |
Provider Name | Bryan D Vanesian |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1346232923 PECOS PAC ID: 8123023959 Enrollment ID: I20060928000465 |
Provider Name | Dena Thamsopit |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1740410307 PECOS PAC ID: 0143369132 Enrollment ID: I20091204000238 |
Provider Name | Jesse Michael Wetzel |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1811595044 PECOS PAC ID: 1052715166 Enrollment ID: I20210811004300 |
Provider Name | Michael E Poblete |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1164196820 PECOS PAC ID: 0345474680 Enrollment ID: I20220428001166 |
Mailing Address | Practice Location Address |
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Bryan D. Vanesian Od A Professional Optometry Corporation 4355 Phelan Rd, Phelan, CA 92371-7675 Ph: (760) 868-2020 | Bryan D. Vanesian Od A Professional Optometry Corporation 4355 Phelan Rd, Phelan, CA 92371-7675 Ph: (760) 868-2020 |
Michael Edward Poblete, OD Optometrist Medicare: Medicare Enrolled Practice Location: 4355 Phelan Rd, Phelan, CA 92371 Phone: 760-868-2020 | |
Dr. Bryan Dean Vanesian, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 4355 Phelan Rd, Phelan, CA 92371 Phone: 760-868-2020 Fax: 760-868-4225 | |
Dr. Dena Thamsopit, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 4355 Phelan Rd, Phelan, CA 92371 Phone: 760-868-2020 Fax: 760-868-7675 | |
Dr. Jesse Michael Wetzel, OD Optometrist Medicare: Medicare Enrolled Practice Location: 4355 Phelan Rd, Phelan, CA 92371 Phone: 760-868-2020 |