| |
1200 N Tustin Ave, Suite # 230, Santa Ana, CA 92705-3508 | |
(714) 647-1200 | |
(714) 647-0200 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 1200 N Tustin Ave, Santa Ana, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1386814994 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OPT12645 TPA (California) | Secondary |
207W00000X | Ophthalmology | A65983 (California) | Primary |
Mailing Address | Practice Location Address |
---|---|
1200 N Tustin Ave, Suite # 230, Santa Ana, CA 92705-3508 Ph: (714) 647-1200 | 1200 N Tustin Ave, Suite # 230, Santa Ana, CA 92705-3508 Ph: (714) 647-1200 |