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General NPI Number Information
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NPI Number | 1932520889
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Entity Type | Organization
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Legal Business Name | EYELOHA EYE CARE OPTOMETRY
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Dates
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Enumeration Date | 12/19/2013
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Last Update Date | 12/19/2013
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Provider Practice Location Address
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Address Line | 1018 GRAND AVE
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City | SAN DIEGO
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State | CA
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Zip | 92109-4117
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Country | US
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Telephone | 858-272-6843
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Fax | 858-272-8143
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Provider Business Mailing Address
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Address Line | 1018 GRAND AVE
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City | SAN DIEGO
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State | CA
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Zip | 92109-4117
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Country | US
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Telephone | 858-272-6843
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Fax | 858-272-8143
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LUCINDA LI
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Credential | OD
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Telephone | 858-272-6843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 10798T
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License Number State | CA
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