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General NPI Number Information
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NPI Number | 1255511796
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Entity Type | Organization
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Legal Business Name | LARCHMONT OPTOMETRICS, INC
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 11/13/2007
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Provider Practice Location Address
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Address Line | 317 N LARCHMONT BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90004-3011
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Country | US
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Telephone | 323-465-9682
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Fax |
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Provider Business Mailing Address
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Address Line | 317 N LARCHMONT BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90004-3011
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Country | US
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Telephone | 323-465-9682
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. MARIA L. AUERBACH
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Credential | O.D.
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Telephone | 323-465-9682
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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 | 12815T
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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 | 9938T
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License Number State | CA
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