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General NPI Number Information
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NPI Number | 1497919765
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Entity Type | Individual
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Provider Name | ALEJANDRO GOMES O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/15/2008
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Last Update Date | 10/31/2013
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Provider Practice Location Address
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Address Line | 26506 BOUQUET CANYON RD
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City | SAUGUS
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State | CA
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Zip | 91350-2353
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Country | US
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Telephone | 661-297-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 5622 VAN NUYS BLVD
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City | SHERMAN OAKS
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State | CA
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Zip | 91401-4602
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Country | US
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Telephone | 818-988-8744
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Fax | 818-988-8756
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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 | 13501
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License Number State | CA
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