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General NPI Number Information
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NPI Number | 1528102928
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Entity Type | Organization
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Legal Business Name | LAURA LEE CLOUTIER,O.D., APC
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Dates
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Enumeration Date | 02/18/2007
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Last Update Date | 01/10/2019
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Provider Practice Location Address
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Address Line | 3800 BARRANCA PKWY STE D
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City | IRVINE
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State | CA
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Zip | 92606-1200
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Country | US
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Telephone | 949-769-6464
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Fax |
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Provider Business Mailing Address
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Address Line | 15 SAN GARIN
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City | IRVINE
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State | CA
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Zip | 92606-8942
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Country | US
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Telephone | 949-439-1962
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. LAURA LEE CLOUTIER
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Credential | O.D.
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Telephone | 949-439-1962
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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 | 9287T
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License Number State | CA
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