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General NPI Number Information
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NPI Number | 1336262377
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER P. LIKENS & NANCY L. WILSON PTR
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 06/27/2013
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Provider Practice Location Address
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Address Line | 4505 BARRANCA PKWY #C
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City | IRVINE
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State | CA
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Zip | 92604-4707
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Country | US
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Telephone | 949-857-0676
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Fax |
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Provider Business Mailing Address
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Address Line | 4505 BARRANCA PKWY #C
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City | IRVINE
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State | CA
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Zip | 92604-4707
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Country | US
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Telephone | 949-857-0676
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER PAUL LIKENS
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Credential | O.D.
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Telephone | 949-857-0676
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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 | 7839T
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License Number State | CA
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