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General NPI Number Information
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NPI Number | 1063597102
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Entity Type | Individual
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Provider Name | MICHAEL LAWRENCE BYRNE O.D.
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Gender | Male
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12819 VALLEY VIEW AVE
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City | LA MIRADA
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State | CA
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Zip | 90638-1945
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Country | US
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Telephone | 562-921-6659
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Fax | 562-921-9374
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Provider Business Mailing Address
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Address Line | 6 DEERFIELD PL
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City | TRABUCO CANYON
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State | CA
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Zip | 92679-1400
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Country | US
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Telephone | 949-858-5492
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Fax | 949-459-7197
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | OP4891T
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License Number State | CA
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