Healthcare Provider Details

I. General information

NPI: 1144233073
Provider Name (Legal Business Name): BRINLEY & MORAD OPTOMETRY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 05/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 LONG BEACH BLVD
LONG BEACH CA
90802-4804
US

IV. Provider business mailing address

37 LONG BEACH BLVD
LONG BEACH CA
90802-4804
US

V. Phone/Fax

Practice location:
  • Phone: 562-436-6739
  • Fax: 562-432-6957
Mailing address:
  • Phone: 562-436-6739
  • Fax: 562-432-6957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. NOAH BRINLEY
Title or Position: PRESIDENT
Credential: O.D.
Phone: 562-436-6739