Booth Optometry Group
Optometrist in Tustin, CA. Organization (NPI-2).
NPI number1861788218
StatusActive
Last updated in NPPESSep 2, 2011
Details
- NPI
- 1861788218
- Entity type
- Organization (NPI-2)
- Legal business name
- Booth Optometry Group
- Organization subpart
- No
- Enumeration date
- Jun 23, 2011
- Last updated
- Sep 2, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | OPT-11505-TPA | CA | Yes |
Practice location
1102 Irvine BlvdTustin, CA 92780-3529
Phone 714-838-3210 · Fax 714-838-5702
Mailing address
1102 Irvine BlvdTustin, CA 92780-3529
Phone 714-838-3210 · Fax 714-838-5702
Authorized official
Amy Louise Kayekjian
Optometrist
7148383210
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