| |
10718 Riverside Dr, Toluca Lake, CA 91602-2313 | |
(818) 985-3937 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 10718 Riverside Dr, Toluca Lake, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1841402484 | NPI | - | NPPES |
1760491948 | Other | CA | PERSONAL NPI # |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 11736T (California) | Primary |
Mailing Address | Practice Location Address |
---|---|
10718 Riverside Dr, Toluca Lake, CA 91602-2313 Ph: (818) 985-3937 | 10718 Riverside Dr, Toluca Lake, CA 91602-2313 Ph: (818) 985-3937 |