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General NPI Number Information
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NPI Number | 1376793828
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Entity Type | Organization
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Legal Business Name | KEDDINGTON & KALRA OPTOMETRISTS APC
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Dates
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Enumeration Date | 09/22/2008
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Last Update Date | 03/10/2009
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Provider Practice Location Address
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Address Line | 1741 EASTLAKE PKWY STE 101
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City | CHULA VISTA
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State | CA
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Zip | 91915-2032
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Country | US
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Telephone | 619-421-6600
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Fax | 619-421-6006
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Provider Business Mailing Address
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Address Line | 1741 EASTLAKE PKWY STE 101
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City | CHULA VISTA
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State | CA
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Zip | 91915-2032
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Country | US
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Telephone | 619-421-6600
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Fax | 619-421-6006
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOAN KEDDINGTON
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Credential | O.D.
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Telephone | 619-421-6600
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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 | 6652
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License Number State | CA
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