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General NPI Number Information
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NPI Number | 1427318492
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Entity Type | Organization
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Legal Business Name | MANILA EYEGLASS CENTER
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Dates
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Enumeration Date | 05/23/2012
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Last Update Date | 05/23/2012
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Provider Practice Location Address
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Address Line | 8340 VAN NUYS BLVD. UNIT E
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City | PANORAMA CITY
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State | CA
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Zip | 91402
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Country | US
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Telephone | 661-965-2551
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Fax |
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Provider Business Mailing Address
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Address Line | 8340 VAN NUYS BLVD. UNIT E
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City | PANORAMA CITY
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State | CA
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Zip | 91402
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Country | US
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Telephone | 661-965-2551
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CECILLE POLICARPIO NAVARRO RIVERA
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Credential | ABOC
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Telephone | 661-965-2551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 7577
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License Number State |
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