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Organization
WOODBRIDGE OPTOMETRY
Active
Organization
WOODBRIDGE OPTOMETRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER PAUL LIKENS O.D. (OWNER)
(949) 857-0676
Entity
Organization
Contact information
Practice address
4040 BARRANCA PKWY, SUITE 110, IRVINE, CA 92604-4766
(949) 857-0676
(949) 857-2175
Mailing address
4040 BARRANCA PARKWAY, SUITE 110, IRVINE, CA 92604-4772
(949) 857-0676
(949) 857-2175
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
14184T
CA
152W00000X
Optometrist
Primary
7839T
CA
152W00000X
Optometrist
8038T
CA
152W00000X
Optometrist
8049T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ68757Y
BLUE SHILED PIN
CA
Enumeration date
12/05/2011
Last updated
12/05/2011
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