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General NPI Number Information
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NPI Number | 1639361611
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Entity Type | Organization
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Legal Business Name | DAVID G KIRSCHEN OD PHD A PROFESSIONAL OPTOMETRIC CORP
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Dates
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Enumeration Date | 08/14/2007
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Last Update Date | 12/29/2015
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Provider Practice Location Address
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Address Line | 428 S BREA BLVD
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City | BREA
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State | CA
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Zip | 92821-5301
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Country | US
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Telephone | 714-529-2470
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Fax | 866-801-4739
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Provider Business Mailing Address
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Address Line | 428 S BREA BLVD
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City | BREA
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State | CA
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Zip | 92821-5301
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Country | US
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Telephone | 714-529-2470
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Fax | 866-801-4739
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID GARY KIRSCHEN
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Credential | OD, PHD
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Telephone | 714-529-2470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OP5418T
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | OP13003T
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | OP5418T
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 152WS0006X
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Taxonomy Name | Sports Vision Optometrist
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License Number | OP5418T
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | OP5418T
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 152WX0102X
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Taxonomy Name | Occupational Vision Optometrist
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License Number | OP13003T
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OP5418T
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License Number State | CA
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