MEDICARE: ROBERTSON OPTOMETRY, PC

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	:	1982256574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERTSON OPTOMETRY, PC

Provider Business Mailing Address
First Line	:	930 S ROBERTSON BLVD STE C
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-1642
Country	:	US
Telephone Number	:	310-274-0653
Fax Number	:

Provider Business Practice Location Address
First Line	:	1421 S ROBERTSON BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-3401
Country	:	US
Telephone Number	:	310-274-0653
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	DR. ESTHER SOPHIA YANG
Credential	:	OD
Telephone Number	:	310-274-0653

Provider Enumeration Date	:	07/12/2019
Last Update Date	:	02/22/2020

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