MEDICARE: ADVANCED FAMILY VISION CENTER OPTOMETRY

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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1083740237
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED FAMILY VISION CENTER OPTOMETRY

Provider Business Mailing Address
First Line	:	19530 VAN BUREN BLVD
Second Line	:	SUITE #G-8
City	:	RIVERSIDE
State	:	CA
Zip	:	92508-9455
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19530 VAN BUREN BLVD
Second Line	:	SUITE #G-8
City	:	RIVERSIDE
State	:	CA
Zip	:	92508-9455
Country	:	US
Telephone Number	:	951-656-0500
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. VALERIE RASNER
Credential	:	O.D.
Telephone Number	:	951-656-0500

Provider Enumeration Date	:	02/24/2007
Last Update Date	:	10/24/2024

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