Healthcare Provider Details

I. General information

NPI: 1538989249
Provider Name (Legal Business Name): DR. CHRISTIAN BEJAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2024
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5465 MEADOWOOD MALL CIR
RENO NV
89502-6710
US

IV. Provider business mailing address

3633 SAVIERS RD APT 16
OXNARD CA
93033-6268
US

V. Phone/Fax

Practice location:
  • Phone: 776-826-7400
  • Fax:
Mailing address:
  • Phone: 805-228-9893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1218
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: