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General NPI Number Information
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NPI Number | 1063997005
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Entity Type | Organization
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Legal Business Name | VINCENT CANO, OD, A PROF CORP
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Dates
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Enumeration Date | 09/26/2018
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Last Update Date | 09/26/2018
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Provider Practice Location Address
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Address Line | 25800 JERONIMO RD STE 701
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City | MISSION VIEJO
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State | CA
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Zip | 92691-7918
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Country | US
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Telephone | 559-859-8856
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Fax |
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Provider Business Mailing Address
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Address Line | 111 STEPPING STONE
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City | IRVINE
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State | CA
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Zip | 92603-0676
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Country | US
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Telephone | 559-859-8856
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO/OPTOMETRIST
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Name | DR. VINCENT CANO
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Credential | O.D.
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Telephone | 559-859-8856
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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 |
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License Number State |
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