| |
17742 Beach Blvd Ste 350, Huntington Beach, CA 92647-6854 | |
(714) 843-5700 | |
(714) 843-5771 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 17742 Beach Blvd Ste 350, Huntington Beach, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1740675644 | NPI | - | NPPES |
1760541569 | Other | CA | GROUP NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | A69909 (California) | Secondary |
174400000X | Specialist | A69909 (California) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
100 E California Blvd, Pasadena, CA 91105-3205 Ph: (626) 568-8838 | 17742 Beach Blvd Ste 350, Huntington Beach, CA 92647-6854 Ph: (714) 843-5700 |