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General NPI Number Information
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NPI Number | 1689661977
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Entity Type | Organization
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Legal Business Name | DR BERNARD LEVIN DR D H DUNCAN DR PERRY S HOM AN OPTOMETRIC CORP
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Dates
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Enumeration Date | 10/01/2005
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 592 S GRAND AVE
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City | COVINA
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State | CA
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Zip | 91724-3467
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Country | US
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Telephone | 626-331-6448
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Fax | 626-332-2515
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Provider Business Mailing Address
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Address Line | 592 S GRAND AVE
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City | COVINA
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State | CA
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Zip | 91724-3467
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Country | US
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Telephone | 626-331-6448
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Fax | 626-332-2515
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Authorized Official
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Title or Position | PRESIDENT / OWNER
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Name | PERRY S HOM
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Credential | OD
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Telephone | 626-331-6448
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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 | COR608
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License Number State | CA
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