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General NPI Number Information
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NPI Number | 1659387462
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Entity Type | Organization
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Legal Business Name | STANTON OPTICAL INC
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 02/13/2013
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Provider Practice Location Address
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Address Line | 9186 W PICO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90035
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Country | US
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Telephone | 310-276-1702
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Fax | 310-276-9715
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Provider Business Mailing Address
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Address Line | 9186 W PICO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90035
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Country | US
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Telephone | 310-276-1702
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Fax | 310-276-9715
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Authorized Official
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Title or Position | MANAGER
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Name | WALTER HOSKIN
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Credential |
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Telephone | 310-276-1702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | D1157
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License Number State | CA
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