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General NPI Number Information
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NPI Number | 1023417896
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Entity Type | Organization
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Legal Business Name | BREA OPTOMETRY
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Dates
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Enumeration Date | 08/18/2014
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Last Update Date | 08/18/2014
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Provider Practice Location Address
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Address Line | 400 W LAMBERT RD SUITE A
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City | BREA
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State | CA
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Zip | 92821-3936
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Country | US
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Telephone | 714-671-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 400 W LAMBERT RD SUITE A
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City | BREA
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State | CA
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Zip | 92821-3936
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Country | US
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Telephone | 714-671-2020
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Fax |
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Authorized Official
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Title or Position | OWNER DOCTOR
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Name | DR. DIANE M ALMANZA
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Credential | OD
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Telephone | 714-671-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 12789T
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License Number State | CA
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