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General NPI Number Information
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NPI Number | 1477606135
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Entity Type | Individual
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Provider Name | YANINA REPKIN O.D.
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Gender | Female
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 09/13/2018
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Provider Practice Location Address
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Address Line | 13425 COMMUNITY RD
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City | POWAY
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State | CA
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Zip | 92064-4723
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Country | US
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Telephone | 858-486-1954
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Fax | 858-486-1963
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Provider Business Mailing Address
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Address Line | PO BOX 1089
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City | POWAY
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State | CA
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Zip | 92074-1089
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Country | US
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Telephone | 858-486-1954
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 12644T
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License Number State | CA
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