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General NPI Number Information
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NPI Number | 1447760988
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Entity Type | Organization
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Legal Business Name | BRIAN L. PARKER, O.D., A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 10/11/2017
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Last Update Date | 10/23/2017
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Provider Practice Location Address
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Address Line | 41720 WINCHESTER RD STE D
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City | TEMECULA
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State | CA
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Zip | 92590-4871
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Country | US
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Telephone | 951-296-1822
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Fax | 951-296-1821
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Provider Business Mailing Address
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Address Line | 41720 WINCHESTER RD STE D
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City | TEMECULA
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State | CA
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Zip | 92590-4871
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Country | US
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Telephone | 951-296-1822
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Fax | 951-296-1821
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. BRIAN LEMOYNE PARKER
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Credential | OD
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Telephone | 951-296-1822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 13818TLG
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License Number State | CA
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