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General NPI Number Information
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NPI Number | 1215161815
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Entity Type | Organization
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Legal Business Name | 20/20 VISION ASSOCIATES OPTOMETRY, INC.
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Dates
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Enumeration Date | 05/11/2009
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Last Update Date | 08/06/2021
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Provider Practice Location Address
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Address Line | 7379 INDIANA AVE
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City | RIVERSIDE
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State | CA
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Zip | 92504-4547
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Country | US
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Telephone | 951-684-7822
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Fax | 951-977-8075
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Provider Business Mailing Address
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Address Line | 7379 INDIANA AVE
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City | RIVERSIDE
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State | CA
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Zip | 92504-4547
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Country | US
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Telephone | 951-684-7822
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Fax | 951-977-8075
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHERYL MARIE 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 | 13309T
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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 | 5187T
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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 | 33508TLG
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #5
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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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