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General NPI Number Information
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NPI Number | 1871833525
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Entity Type | Organization
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Legal Business Name | FASHION VALLEY EYECARE
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Dates
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Enumeration Date | 02/17/2013
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Last Update Date | 02/17/2013
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Provider Practice Location Address
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Address Line | 7007 FRIARS RD STE 667A
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City | SAN DIEGO
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State | CA
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Zip | 92108-1148
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Country | US
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Telephone | 619-297-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 7007 FRIARS RD STE 667A
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City | SAN DIEGO
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State | CA
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Zip | 92108-1148
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Country | US
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Telephone | 619-297-2020
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. BOBBY DARRELL SMITH II
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Credential | OD
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Telephone | 619-829-5859
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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 | 13941
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License Number State | CA
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