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General NPI Number Information
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NPI Number | 1265658694
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Entity Type | Organization
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Legal Business Name | COMPLETE EYE CARE CENTER
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17001 HAWTHORNE BLVD
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City | LAWNDALE
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State | CA
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Zip | 90260-3302
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Country | US
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Telephone | 310-370-7575
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Fax | 310-370-6227
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Provider Business Mailing Address
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Address Line | 17001 HAWTHORNE BLVD
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City | LAWNDALE
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State | CA
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Zip | 90260-3302
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Country | US
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Telephone | 310-370-7575
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Fax | 310-370-6227
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Authorized Official
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Title or Position | MANAGER
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Name | MR. ADAM ROSSIE
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Credential |
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Telephone | 310-370-7575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 03621
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License Number State | CA
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