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General NPI Number Information
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NPI Number | 1538437835
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Entity Type | Organization
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Legal Business Name | CALIFORNIA EYE PROSTHETICS, INC
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Dates
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Enumeration Date | 12/01/2011
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Last Update Date | 12/01/2011
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Provider Practice Location Address
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Address Line | 635 C ST SUITE 502
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City | SAN DIEGO
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State | CA
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Zip | 92101-5318
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Country | US
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Telephone | 619-235-8950
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Fax |
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Provider Business Mailing Address
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Address Line | 635 C ST SUITE 502
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City | SAN DIEGO
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State | CA
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Zip | 92101-5318
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Country | US
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Telephone | 619-235-8950
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Fax |
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Authorized Official
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Title or Position | OCULARIST
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Name | DANIEL THOMAS ACOSTA
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Credential | BCO
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Telephone | 619-235-8950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1700X
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Taxonomy Name | Ocularist
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License Number |
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License Number State |
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