Healthcare Provider Details

I. General information

NPI: 1801892773
Provider Name (Legal Business Name): MARK WILLIAM ALPERT O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 05/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16102 BELLFLOWER BLVD
BELLFLOWER CA
90706-4606
US

IV. Provider business mailing address

16102 BELLFLOWER BLVD
BELLFLOWER CA
90706-4606
US

V. Phone/Fax

Practice location:
  • Phone: 562-867-4716
  • Fax: 562-925-6877
Mailing address:
  • Phone: 562-867-4716
  • Fax: 562-925-6877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number04969TPA
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: