Healthcare Provider Details

I. General information

NPI: 1982324653
Provider Name (Legal Business Name): DCB OPTOMETRY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2022
Last Update Date: 09/01/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12819 VALLEY VIEW AVE
LA MIRADA CA
90638-1945
US

IV. Provider business mailing address

10562 RITTER ST
CYPRESS CA
90630-4944
US

V. Phone/Fax

Practice location:
  • Phone: 562-921-6659
  • Fax: 562-921-9374
Mailing address:
  • Phone: 714-625-6433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. DEBBIE CHEN-BENNETT
Title or Position: OPTOMETRIST
Credential: OD
Phone: 714-625-6433