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General NPI Number Information
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NPI Number | 1316181563
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Entity Type | Organization
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Legal Business Name | SMIT A. PATEL O.D., AND IRENE GENDELMAN O.D., APOC
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Dates
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Enumeration Date | 04/30/2009
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Last Update Date | 09/01/2015
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Provider Practice Location Address
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Address Line | 9349 MISSION GORGE RD #114
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City | SANTEE
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State | CA
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Zip | 92071-3886
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Country | US
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Telephone | 858-405-9484
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Fax |
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Provider Business Mailing Address
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Address Line | 9349 MISSION GORGE RD #114
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City | SANTEE
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State | CA
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Zip | 92071-3886
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IRENE GENDELMAN PATEL
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Credential | O,D,
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Telephone | 858-405-9584
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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 | 13305 T
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License Number State | CA
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