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General NPI Number Information
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NPI Number | 1093909541
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Entity Type | Organization
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Legal Business Name | MELTZER VISION CENTER
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Dates
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Enumeration Date | 08/28/2007
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Last Update Date | 09/05/2013
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Provider Practice Location Address
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Address Line | 615 W AVENUE Q SUITE C
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City | PALMDALE
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State | CA
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Zip | 93551-3887
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Country | US
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Telephone | 661-480-0469
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Fax | 661-480-0534
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Provider Business Mailing Address
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Address Line | 615 W AVENUE Q SUITE C
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City | PALMDALE
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State | CA
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Zip | 93551-3887
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Country | US
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Telephone | 661-480-0469
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Fax | 661-480-0534
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Authorized Official
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Title or Position | OWNER
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Name | MR. HARVEY LESLIE MELTZER
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Credential | RDO
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Telephone | 661-480-0469
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | SL274
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License Number State | CA
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