Healthcare Provider Details

I. General information

NPI: 1174004212
Provider Name (Legal Business Name): PARAMOUNT FAMILY OPTOMETRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2018
Last Update Date: 03/25/2020
Certification Date: 03/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14905 PARAMOUNT BLVD STE E
PARAMOUNT CA
90723-3440
US

IV. Provider business mailing address

14905 PARAMOUNT BLVD STE E
PARAMOUNT CA
90723-3440
US

V. Phone/Fax

Practice location:
  • Phone: 562-633-6046
  • Fax: 562-633-0260
Mailing address:
  • Phone:
  • 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. JESUS RAMON MERINO
Title or Position: OWNER
Credential: OD
Phone: 562-633-6046