Healthcare Provider Details

I. General information

NPI: 1003361270
Provider Name (Legal Business Name): IGNE OPTOMETRIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2016
Last Update Date: 01/10/2022
Certification Date: 01/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 BARRANCA PKWY STE 101
IRVINE CA
92604-4630
US

IV. Provider business mailing address

4950 BARRANCA PKWY STE 101
IRVINE CA
92604-4630
US

V. Phone/Fax

Practice location:
  • Phone: 949-733-1400
  • Fax: 949-559-8984
Mailing address:
  • Phone: 949-733-1400
  • Fax: 949-559-8984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT14967TLG
License Number StateCA

VIII. Authorized Official

Name: DR. ERIN LOUISE IGNE
Title or Position: OPTOMETRIST
Credential: OD
Phone: 949-733-1400