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NPI Code Detail

MEDICARE: DR. COREY ALAN HODES O.D.

MEDICARE: DR. COREY ALAN HODES 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
1152W00000XOptometrist11651TCA

General Provider Information

NPI Number : 1831152214
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. COREY ALAN HODES O.D.
Provider Business Mailing Address
First Line : 10511 W PICO BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-2319
Country : US
Telephone Number : 310-277-2726
Fax Number :
Provider Business Practice Location Address
First Line : 10511 W PICO BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-2319
Country : US
Telephone Number : 310-475-1903
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2006
Last Update Date : 02/17/2020

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