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NPI Code Detail

MEDICARE: CATHERINE EGUSA O.D.

MEDICARE: CATHERINE EGUSA O.D.
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
1152W00000XOptometrist11628TCA
2152W00000XOptometristOD-579HI
3152W00000XOptometristOD0000002403TN

General Provider Information

NPI Number : 1326093394
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHERINE EGUSA O.D.
Provider Business Mailing Address
First Line : 1840 WEST DR
Second Line : SUITE 107
City : VISTA
State : CA
Zip : 92083-6115
Country : US
Telephone Number : 760-643-2084
Fax Number : 760-643-2099
Provider Business Practice Location Address
First Line : 1840 WEST DR
Second Line : SUITE 107
City : VISTA
State : CA
Zip : 92083-6115
Country : US
Telephone Number : 760-643-2084
Fax Number : 760-643-2099
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2006
Last Update Date : 07/08/2007

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