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General NPI Number Information
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NPI Number | 1770668717
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Entity Type | Individual
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Provider Name | MIRIAM BELTRAN FUCHS O.D.
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Gender | Female
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 08/17/2010
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Provider Practice Location Address
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Address Line | 1800 UNIVERSITY DR
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City | VISTA
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State | CA
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Zip | 92083-7700
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Country | US
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Telephone | 760-631-7914
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Fax | 760-631-7915
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Provider Business Mailing Address
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Address Line | 705 ALAMO LN
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City | ESCONDIDO
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State | CA
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Zip | 92025-7650
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Country | US
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Telephone | 619-587-4427
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Fax | 760-631-7915
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | OPT 12992 TPA
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License Number State | CA
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