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General NPI Number Information
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NPI Number | 1922017896
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Entity Type | Organization
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Legal Business Name | RANCHO SANTA FE OPTOMETRY APC
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 6037 LA GRANADA
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City | RANCHO SANTA FE
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State | CA
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Zip | 92067-0275
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Country | US
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Telephone | 858-756-3210
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Fax | 858-756-3910
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Provider Business Mailing Address
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Address Line | PO BOX 275
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City | RANCHO SANTA FE
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State | CA
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Zip | 92067-0275
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Country | US
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Telephone | 858-756-3210
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Fax | 858-756-3910
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SANDY PIERCE
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Credential |
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Telephone | 858-756-3210
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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 | COR 1153
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License Number State | CA
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