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General NPI Number Information
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NPI Number | 1093992406
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Entity Type | Organization
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Legal Business Name | EILEEN J. BELL
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 06/25/2015
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Provider Practice Location Address
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Address Line | 302 W GRAND AVE SUITE #1
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City | EL SEGUNDO
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State | CA
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Zip | 90245-3700
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Country | US
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Telephone | 310-414-9595
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Fax | 310-414-0137
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Provider Business Mailing Address
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Address Line | 302 W GRAND AVE SUITE #1
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City | EL SEGUNDO
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State | CA
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Zip | 90245-3700
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Country | US
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Telephone | 310-414-9595
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Fax | 310-414-0137
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Authorized Official
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Title or Position | OWNER / OPTOMETRIST
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Name | DR. EILEEN J. BELL
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Credential | O.D.
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Telephone | 310-414-9595
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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 | 12119 T
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 8192 T
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License Number State | CA
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