Healthcare Provider Details

I. General information

NPI: 1346305869
Provider Name (Legal Business Name): NINA COLEEN GETZ OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W HUNTINGTON DR STE 605
ARCADIA CA
91007-1514
US

IV. Provider business mailing address

1834 W MOSSBERG AVE
WEST COVINA CA
91790-2611
US

V. Phone/Fax

Practice location:
  • Phone: 626-446-1600
  • Fax: 626-446-9986
Mailing address:
  • Phone: 626-688-5947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License NumberOPT9455
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: