Healthcare Provider Details

I. General information

NPI: 1831268903
Provider Name (Legal Business Name): CAROLINE GUERRERO CAUCHI O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 09/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8235 UNIVERSITY AVE
LA MESA CA
91942-9320
US

IV. Provider business mailing address

8235 UNIVERSITY AVE
LA MESA CA
91942-9320
US

V. Phone/Fax

Practice location:
  • Phone: 619-461-4913
  • Fax: 619-465-5070
Mailing address:
  • Phone: 619-461-4913
  • Fax: 619-465-5070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number6882T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: