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General NPI Number Information
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NPI Number | 1134309222
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Entity Type | Organization
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Legal Business Name | CARL A BOECK & RONALD W SCHISLER PTR
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 9621 MISSION GORGE RD 106
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City | SANTEE
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State | CA
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Zip | 92071-3802
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Country | US
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Telephone | 619-449-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 9621 MISSION GORGE RD 106
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City | SANTEE
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State | CA
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Zip | 92071-3802
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Country | US
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Telephone | 619-449-2000
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Fax |
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Authorized Official
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Title or Position | PARTNER/OWNER
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Name | DR. CARL ALLEN BOECK
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Credential | O.D.
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Telephone | 619-449-2000
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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 | OPT6791T-G
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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 | OPT6620T
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License Number State | CA
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