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435 W Aten Rd Ste 3, Imperial, CA 92251-9819 | |
(619) 370-7315 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 435 W Aten Rd Ste 3, Imperial, 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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1750169017 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | (* (Not Available)) | Primary |
Provider Name | Raul Alex Mancilla |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1487706198 PECOS PAC ID: 6608047857 Enrollment ID: I20240430004275 |
Mailing Address | Practice Location Address |
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435 W Aten Rd Ste 3, Imperial, CA 92251-9819 Ph: (619) 370-7315 | 435 W Aten Rd Ste 3, Imperial, CA 92251-9819 Ph: (619) 370-7315 |
Dr. Raul Alex Mancilla, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 435 W Aten Rd Ste 3, Imperial, CA 92251 Phone: 760-284-1442 Fax: 760-203-3930 |