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Organization
JOHN C PACK, O.D. AND BEVERLY BIANES, O.D. INC
Active
Organization
JOHN C PACK, O.D. AND BEVERLY BIANES, O.D. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA L FORTE (OFFICE MANAGER)
(619) 425-7990
Entity
Organization
Contact information
Practice address
374 E H ST, SUITE 1708, CHULA VISTA, CA 91910-7484
(619) 425-7990
(619) 425-7992
Mailing address
374 E H ST, SUITE 1708, CHULA VISTA, CA 91910-7484
(619) 425-7990
(619) 425-7992
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255396461
BLUE CROSS OF CALIFORNIA
CA
05
—
GSD005620
—
CA
Enumeration date
04/19/2006
Last updated
11/27/2013
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