| |
4413 Lajolla Village Dr., Spc. P1, San Diego, CA 92122 | |
(858) 320-0075 | |
(858) 320-0053 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 4413 Lajolla Village Dr., San Diego, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1427301894 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (California) | Secondary |
207W00000X | Ophthalmology | (California) | Primary |
Mailing Address | Practice Location Address |
---|---|
6945 El Cajon Blvd, San Diego, CA 92115-1754 Ph: (619) 697-4600 | 4413 Lajolla Village Dr., Spc. P1, San Diego, CA 92122 Ph: (858) 320-0075 |