| |
19582 Beach Blvd Ste 322, Huntington Beach, CA 92648-5924 | |
(714) 965-9696 | |
(714) 965-9797 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 19582 Beach Blvd Ste 322, Huntington Beach, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699886606 | NPI | - | NPPES |
GR0085210 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
19582 Beach Blvd Ste 322, Huntington Beach, CA 92648-5924 Ph: (714) 965-9696 | 19582 Beach Blvd Ste 322, Huntington Beach, CA 92648-5924 Ph: (714) 965-9696 |