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NPI Code Detail

MEDICARE: LAURA K. HA OD OPTOMETRY A PROFESSIONAL CORPORATION

MEDICARE: LAURA K. HA OD OPTOMETRY A PROFESSIONAL CORPORATION
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
1152WV0400XVision Therapy Optometrist13789CA
2152W00000XOptometrist13789CA

General Provider Information

NPI Number : 1588940647
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAURA K. HA OD OPTOMETRY A PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 7217 RESEDA BLVD
Second Line :
City : RESEDA
State : CA
Zip : 91335-3046
Country : US
Telephone Number : 818-345-2010
Fax Number : 818-345-2070
Provider Business Practice Location Address
First Line : 7217 RESEDA BLVD
Second Line :
City : RESEDA
State : CA
Zip : 91335-3046
Country : US
Telephone Number : 818-345-2010
Fax Number : 818-345-2070
Authorized Official
Title or Position : CEO/ OPTOMETRIST
Name : DR. LAURA K HA
Credential : OD
Telephone Number : 818-345-2010
Provider Enumeration Date : 11/02/2011
Last Update Date : 01/18/2012

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