MEDICARE: HART OPTICAL COMPANY OF LA MESA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician

General Provider Information

NPI Number	:	1033386594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HART OPTICAL COMPANY OF LA MESA

Provider Business Mailing Address
First Line	:	8685 LA MESA BLVD
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91941-3903
Country	:	US
Telephone Number	:	619-466-6825
Fax Number	:	619-462-9239

Provider Business Practice Location Address
First Line	:	8685 LA MESA BLVD
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91941-3903
Country	:	US
Telephone Number	:	619-466-6825
Fax Number	:	619-462-9239

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL A EMERSON
Credential	:
Telephone Number	:	619-466-6825

Provider Enumeration Date	:	05/14/2008
Last Update Date	:	05/14/2008

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Directions to “HART OPTICAL COMPANY OF LA MESA ” Practice Location

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