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General NPI Number Information
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NPI Number | 1750947297
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Entity Type | Organization
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Legal Business Name | DR. MIKE LI OPTOMETRY INC
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Dates
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Enumeration Date | 05/09/2019
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Last Update Date | 05/09/2019
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Provider Practice Location Address
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Address Line | 6250 VALLEY SPRINGS PKWY
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City | RIVERSIDE
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State | CA
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Zip | 92507-0970
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Country | US
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Telephone | 951-656-7218
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Fax |
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Provider Business Mailing Address
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Address Line | 23811 WASHINGTON AVE STE C110
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City | MURRIETA
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State | CA
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Zip | 92562-2277
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Country | US
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Telephone | 951-656-7218
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. DR MIKE LI
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Credential |
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Telephone | 951-656-7218
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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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