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General NPI Number Information
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NPI Number | 1295984318
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Entity Type | Organization
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Legal Business Name | RICHARD L FORGEY LORI L MATSUNO PARTNERSHIP
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Dates
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Enumeration Date | 09/12/2008
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Last Update Date | 10/22/2009
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Provider Practice Location Address
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Address Line | 210 S GRAND AVE SUITE 115
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City | GLENDORA
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State | CA
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Zip | 91741-4263
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Country | US
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Telephone | 626-857-0234
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Fax | 626-857-0857
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Provider Business Mailing Address
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Address Line | 210 S GRAND AVE SUITE 115
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City | GLENDORA
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State | CA
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Zip | 91741-4263
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Country | US
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Telephone | 626-857-0234
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Fax | 626-857-0857
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Authorized Official
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Title or Position | PARTNER
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Name | DR. LORI LYNN MATSUNO
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Credential | OD
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Telephone | 626-857-0234
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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 | OPT8800T
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License Number State | CA
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