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801 N Tustin Ave, Ste 404, Santa Ana, CA 92705-3612 | |
(714) 558-1182 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Ophthalmology |
Location | 801 N Tustin Ave, Santa Ana, California |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1548433477 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | OP9763T (California) | Secondary |
207W00000X | Ophthalmology | OP9763 (California) | Primary |
Provider Name | Alexander M Bonakdar |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1588668917 PECOS PAC ID: 0941228373 Enrollment ID: I20101222000314 |
Mailing Address | Practice Location Address |
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801 N Tustin Ave, Ste 404, Santa Ana, CA 92705-3612 Ph: (714) 558-1182 | 801 N Tustin Ave, Ste 404, Santa Ana, CA 92705-3612 Ph: (714) 558-1182 |