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General NPI Number Information
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NPI Number | 1760626659
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Entity Type | Organization
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Legal Business Name | ERIC J KAWATA O D INC
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Dates
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Enumeration Date | 04/23/2009
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Last Update Date | 02/04/2010
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Provider Practice Location Address
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Address Line | 101 E LINCOLN AVE SUITE 103
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City | ANAHEIM
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State | CA
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Zip | 92805-3202
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Country | US
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Telephone | 714-535-7515
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Fax | 714-535-1870
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Provider Business Mailing Address
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Address Line | 101 E LINCOLN AVE SUITE 103
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City | ANAHEIM
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State | CA
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Zip | 92805-3202
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Country | US
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Telephone | 714-535-7515
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Fax | 714-535-1870
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIC J KAWATA
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Credential | OD
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Telephone | 714-535-7515
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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 | 08259T
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License Number State | CA
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