| |
265 Laguna Rd, Fullerton, CA 92835-2515 | |
(714) 871-2570 | |
(714) 441-2020 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 265 Laguna Rd, Fullerton, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679818264 | NPI | - | NPPES |
1063553378 | Other | CA | INDIVIDUAL NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 10328T (California) | Secondary |
152W00000X | Optometrist | 6488T (California) | Secondary |
207W00000X | Ophthalmology | A41428 (California) | Primary |
Mailing Address | Practice Location Address |
---|---|
265 Laguna Rd, Fullerton, CA 92835-2515 Ph: (714) 871-2570 | 265 Laguna Rd, Fullerton, CA 92835-2515 Ph: (714) 871-2570 |