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General NPI Number Information
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NPI Number | 1720024243
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Entity Type | Organization
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Legal Business Name | MCMAHON OPTOMETRIC CORPORATION
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 700 W 7TH ST STE G260
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City | LOS ANGELES
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State | CA
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Zip | 90017-3786
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Country | US
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Telephone | 213-623-5196
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Fax |
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Provider Business Mailing Address
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Address Line | 700 W 7TH ST SUITE G260
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City | LOS ANGELES
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State | CA
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Zip | 90017-3768
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Country | US
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Telephone | 213-623-5196
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELIZABETH MCMAHON
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Credential | OD
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Telephone | 213-623-5196
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT5029TPL
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License Number State | CA
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