MEDICARE: JEFFREY ANSHEL O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPT 5980	CA

General Provider Information

NPI Number	:	1750386843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY ANSHEL O.D.

Provider Business Mailing Address
First Line	:	128 W E ST
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92024-3519
Country	:	US
Telephone Number	:	760-931-1390
Fax Number	:

Provider Business Practice Location Address
First Line	:	128 W E ST
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92024-3519
Country	:	US
Telephone Number	:	760-931-1390
Fax Number	:	760-931-9545

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	07/16/2019

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