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General NPI Number Information
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NPI Number | 1366544363
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Entity Type | Individual
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Provider Name | IRENA BEKHTEL OD
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Gender | Female
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 10/30/2012
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Provider Practice Location Address
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Address Line | 4762 SAINT ANDREWS DR
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City | STOCKTON
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State | CA
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Zip | 95219-1915
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Country | US
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Telephone | 209-594-0554
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Fax |
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Provider Business Mailing Address
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Address Line | 4915 CLAREMONT AVE
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City | STOCKTON
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State | CA
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Zip | 95207-5707
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Country | US
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Telephone | 209-956-3323
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4104
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 12748
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC3279
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License Number State | FL
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