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General NPI Number Information
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NPI Number | 1356813711
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Entity Type | Organization
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Legal Business Name | TOTAL VISION PC
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Dates
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Enumeration Date | 12/26/2018
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 11717 BERNARDO PLAZA CT STE 105
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City | SAN DIEGO
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State | CA
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Zip | 92128-2419
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Country | US
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Telephone | 858-487-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 27271 LAS RAMBLAS STE 210
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City | MISSION VIEJO
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State | CA
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Zip | 92691-8041
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Country | US
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Telephone | 949-652-7230
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Fax |
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Authorized Official
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Title or Position | CLINICAL FIELD DIRECTOR
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Name | PATRICK AUBURN GRIFFIN
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Credential |
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Telephone | 949-940-0200
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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 |
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License Number State |
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