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General NPI Number Information
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NPI Number | 1124241948
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Entity Type | Organization
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Legal Business Name | EYE WORLD OPTOMETRY
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 01/11/2008
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Provider Practice Location Address
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Address Line | 13721 NEWPORT AVE SUITE 5
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City | TUSTIN
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State | CA
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Zip | 92780-4601
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Country | US
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Telephone | 714-730-1318
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Fax | 714-730-1388
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Provider Business Mailing Address
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Address Line | 13721 NEWPORT AVE SUITE 5
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City | TUSTIN
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State | CA
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Zip | 92780-4601
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Country | US
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Telephone | 714-730-1318
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Fax | 714-730-1388
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. HELENE LEANG
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Credential | O.D.
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Telephone | 714-730-1318
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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 | 11283T
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License Number State | CA
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