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3680 Wilshire Blvd, Suite 105, La, CA 90010 | |
(213) 386-0001 | |
(213) 386-1001 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 3680 Wilshire Blvd, La, 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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1134618986 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | (* (Not Available)) | Primary |
Provider Name | Julie S Chang |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1457404683 PECOS PAC ID: 7214070481 Enrollment ID: I20100210000424 |
Provider Name | Austin Lorenzo Ofreneo |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1568742591 PECOS PAC ID: 9638413149 Enrollment ID: I20181210001801 |
Mailing Address | Practice Location Address |
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3680 Wilshire Blvd, Suite 105, La, CA 90010 Ph: (213) 386-0001 | 3680 Wilshire Blvd, Suite 105, La, CA 90010 Ph: (213) 386-0001 |