| |
231 W Vernon Ave Ste 104, Los Angeles, CA 90037-2778 | |
(310) 819-9500 | |
(323) 703-1301 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 231 W Vernon Ave Ste 104, Los Angeles, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619597119 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
1595 E 17th St, Santa Ana, CA 92705-8506 Ph: (714) 399-0678 | 231 W Vernon Ave Ste 104, Los Angeles, CA 90037-2778 Ph: (310) 819-9500 |