Healthcare Provider Details

I. General information

NPI: 1316260052
Provider Name (Legal Business Name): THE CENTER FOR THE PARTIALLY SIGHTED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2010
Last Update Date: 03/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18425 BURBANK BLVD STE 706
TARZANA CA
91356-6668
US

IV. Provider business mailing address

18425 BURBANK BLVD STE 706
TARZANA CA
91356-6668
US

V. Phone/Fax

Practice location:
  • Phone: 818-705-5954
  • Fax:
Mailing address:
  • Phone: 818-705-5954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number960000461
License Number StateCA

VIII. Authorized Official

Name: LADONNA S RINGERING
Title or Position: PRESIDENT AND CEO
Credential: PH.D.
Phone: 310-988-1970