MEDICARE: DR. REX AARON WERNER 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
1	152W00000X	Optometrist	CA 13478TPA	CA
2	152WV0400X	Vision Therapy Optometrist	CA 13478TPA	CA

General Provider Information

NPI Number	:	1821259458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REX AARON WERNER O.D.

Provider Business Mailing Address
First Line	:	2650 JAMACHA RD
Second Line	:	SUITE 155
City	:	EL CAJON
State	:	CA
Zip	:	92019-4319
Country	:	US
Telephone Number	:	619-670-6296
Fax Number	:	619-670-8852

Provider Business Practice Location Address
First Line	:	2650 JAMACHA RD
Second Line	:	SUITE 155
City	:	EL CAJON
State	:	CA
Zip	:	92019-4319
Country	:	US
Telephone Number	:	619-670-6296
Fax Number	:	619-670-8852

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2008
Last Update Date	:	06/17/2008

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