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General NPI Number Information
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NPI Number | 1457519100
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Entity Type | Organization
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Legal Business Name | ALMAR VISTA INC
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Dates
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Enumeration Date | 05/29/2008
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Last Update Date | 05/29/2008
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Provider Practice Location Address
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Address Line | 14506 S CRENSHAW BLVD
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City | GARDENA
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State | CA
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Zip | 90249-3158
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Country | US
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Telephone | 310-324-3139
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Fax | 310-324-7052
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Provider Business Mailing Address
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Address Line | 14506 CRENSHAW BLVD
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City | GARDENA
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State | CA
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Zip | 90249-3158
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Country | US
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Telephone | 310-324-3139
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Fax | 310-324-7052
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PETER HOA NGUYEN
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Credential | OD
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Telephone | 310-324-3139
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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 | OP9919T
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License Number State | CA
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