MEDICARE: MICHAEL MORGAN OD, INC.

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	:	1396481750
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL MORGAN OD, INC.

Provider Business Mailing Address
First Line	:	2110 S COAST HWY STE D
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6544
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2110 S COAST HWY STE D
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6544
Country	:	US
Telephone Number	:	760-573-6226
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL MORGAN
Credential	:	OD
Telephone Number	:	619-719-9162

Provider Enumeration Date	:	05/09/2022
Last Update Date	:	05/09/2022

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