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General NPI Number Information
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NPI Number | 1073829107
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Entity Type | Organization
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Legal Business Name | OPTIMA FAMILY SERVICES, INC.
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Dates
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Enumeration Date | 08/26/2010
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Last Update Date | 08/26/2010
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Provider Practice Location Address
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Address Line | 1288 N VERDUGO RD SUITE A
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City | GLENDALE
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State | CA
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Zip | 91206-1546
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Country | US
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Telephone | 818-844-3376
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Fax | 818-844-0888
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Provider Business Mailing Address
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Address Line | 1288 N VERDUGO RD SUITE A
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City | GLENDALE
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State | CA
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Zip | 91206-1546
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Country | US
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Telephone | 818-844-3376
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Fax | 818-844-0888
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. OSCAR ALONSO CARVAJAL
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Credential |
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Telephone | 818-844-3376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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