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General NPI Number Information
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NPI Number | 1093795544
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Entity Type | Organization
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Legal Business Name | EAP OPTOMETRY
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6541 E SPRING ST
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City | LONG BEACH
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State | CA
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Zip | 90808-4023
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Country | US
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Telephone | 562-496-3365
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Fax | 562-496-2764
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Provider Business Mailing Address
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Address Line | 6541 E SPRING ST
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City | LONG BEACH
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State | CA
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Zip | 90808-4023
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Country | US
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Telephone | 562-496-3365
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHEN HOR-BENG EAP
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Credential | O.D., J.D.
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Telephone | 562-496-3365
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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 | OPT10107T
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License Number State | CA
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