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General NPI Number Information
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NPI Number | 1124222997
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Entity Type | Organization
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Legal Business Name | 20 -20 VISION ASSOCIATES OPTOMETRY
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 06/04/2009
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Provider Practice Location Address
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Address Line | 6377 RIVERSIDE AVE SUITE 190
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City | RIVERSIDE
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State | CA
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Zip | 92506-3124
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Country | US
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Telephone | 951-684-7822
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Fax | 951-684-0733
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Provider Business Mailing Address
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Address Line | 6377 RIVERSIDE AVE SUITE 190
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City | RIVERSIDE
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State | CA
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Zip | 92506-3124
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Country | US
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Telephone | 951-684-7822
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Fax | 951-684-0733
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Authorized Official
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Title or Position | PRACTICE OWNER, PARTNER
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Name | MS. CHERYL M. EVERITT
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Credential | O.D.
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Telephone | 951-684-7822
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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 | 10316T
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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 | 13309T
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5187T
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License Number State | CA
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