| |
2137 E Lincoln Ave, Anaheim, CA 92806-4106 | |
(251) 401-2096 | |
(714) 999-1439 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center |
Location | 2137 E Lincoln Ave, Anaheim, California |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1518733567 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Steven V Previsich |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1093889982 PECOS PAC ID: 3678865227 Enrollment ID: I20240930001829 |
Mailing Address | Practice Location Address |
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2137 E Lincoln Ave, Anaheim, CA 92806-4106 Ph: (251) 401-2096 | 2137 E Lincoln Ave, Anaheim, CA 92806-4106 Ph: (251) 401-2096 |