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General NPI Number Information
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NPI Number | 1952482820
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Entity Type | Organization
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Legal Business Name | MURRIETA OPTOMETRY INC
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 11/26/2019
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Provider Practice Location Address
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Address Line | 1171 MURRIETA BLVD STE 100
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City | LIVERMORE
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State | CA
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Zip | 94550-4143
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Country | US
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Telephone | 925-443-3553
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Fax | 925-447-8500
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Provider Business Mailing Address
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Address Line | 1171 MURRIETA BLVD STE 100
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City | LIVERMORE
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State | CA
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Zip | 94550-4143
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Country | US
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Telephone | 925-443-3553
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Fax | 925-447-8500
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOTT MARSHALL KAMENA
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Credential | OD
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Telephone | 925-443-3553
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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 | OPT11158TPA
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License Number State | CA
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