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General NPI Number Information
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NPI Number | 1457537946
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Entity Type | Organization
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Legal Business Name | RIVIERA VILLAGE OPTOMETRY PC
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Dates
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Enumeration Date | 01/14/2008
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Last Update Date | 02/07/2013
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Provider Practice Location Address
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Address Line | 239 AVENIDA DEL NORTE
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City | REDONDO BEACH
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State | CA
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Zip | 90277-5702
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Country | US
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Telephone | 310-540-5545
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Fax | 310-540-5536
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Provider Business Mailing Address
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Address Line | 239 AVENIDA DEL NORTE
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City | REDONDO BEACH
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State | CA
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Zip | 90277-5702
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Country | US
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Telephone | 310-540-5545
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Fax | 310-540-5536
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. LYNN OKU
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Credential | O.D.
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Telephone | 310-540-5545
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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 |
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License Number State |
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