| |
12000 Victory Blvd, North Hollywwod, CA 91606 | |
(818) 985-2321 | |
(818) 985-6873 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 12000 Victory Blvd, North Hollywwod, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1881815777 | NPI | - | NPPES |
SD0051040 | Medicaid | CA | |
GSD005410 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (California) | Primary |
Mailing Address | Practice Location Address |
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12000 Victory Blvd, North Hollywwod, CA 91606 Ph: (818) 985-2321 | 12000 Victory Blvd, North Hollywwod, CA 91606 Ph: (818) 985-2321 |