Organization · NPI-2

Brett P. Bowman Od., Professional Optometry Corporation

Optometrist · Corona, CA

NPI number1336492586
StatusActive
Last updated in NPPESOct 24, 2012

Details

NPI
1336492586
Entity type
Organization (NPI-2)
Legal business name
Brett P. Bowman Od., Professional Optometry Corporation
Organization subpart
No
Enumeration date
Oct 24, 2012
Last updated
Oct 24, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X OptometristOPT 10289TCAYes

Practice location

1810 Fullerton Ave
Suite 201
Corona, CA 92881-3103

Phone 951-737-0477 · Fax 951-737-0565

Mailing address

1810 Fullerton Ave
Suite 201
Corona, CA 92881-3103

Phone 951-737-0477 · Fax 951-737-0565

Authorized official

Brett P Bowman
Owner
9517370477

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