Healthcare Provider Details

I. General information

NPI: 1326471038
Provider Name (Legal Business Name): FOOTHILL RANCH EYE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2013
Last Update Date: 08/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26730 TOWNE CENTRE DR STE 204
FOOTHILL RANCH CA
92610-2842
US

IV. Provider business mailing address

26730 TOWNE CENTRE DR STE 204
FOOTHILL RANCH CA
92610-2842
US

V. Phone/Fax

Practice location:
  • Phone: 949-264-3931
  • Fax: 480-287-8507
Mailing address:
  • Phone: 949-264-3931
  • Fax: 480-287-8507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. CLAUDIA MONTANA-COLLINS
Title or Position: DOCTOR OF OPTOMETRY
Credential:
Phone: 949-264-3931