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Organization
HERTZOG OPTICAL, LLC
Active
Organization
HERTZOG OPTICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEIF MARK HERTZOG M.D. (OWNER)
(562) 595-8587
Entity
Organization
Contact information
Practice address
2977 REDONDO AVE, LONG BEACH, CA 90806-2445
(562) 595-8587
Mailing address
2977 REDONDO AVE, LONG BEACH, CA 90806-2445
(562) 595-8587
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G52761
CA
Other
Enumeration date
01/09/2007
Last updated
03/05/2009
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