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Organization
OPTOMETRIC SPECIALTIES INC
Active
Organization
OPTOMETRIC SPECIALTIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC E GAYLORD O.D. (OWNER)
(323) 294-7517
Entity
Organization
Contact information
Practice address
3750 SANTA ROSALIA DR STE 102, LOS ANGELES, CA 90008-3685
(323) 294-7517
Mailing address
3750 SANTA ROSALIA DR STE 102, LOS ANGELES, CA 90008-3685
(323) 294-7517
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
COR 889
CA
332H00000X
Eyewear Supplier
COR 889
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GSD004160
—
CA
Enumeration date
12/16/2005
Last updated
06/16/2018
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