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Organization
MINTZ FAMILY OPTOMETRY, APC
Active
Organization
MINTZ FAMILY OPTOMETRY, APC
Active
Other names
Irwin H. Mintz, OD, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DENA M. MINTZ OD (PRESIDENT)
(909) 985-2876
Entity
Organization
Contact information
Practice address
553 NORTH MOUNTAIN AVENUE, UPLAND, CA 91786-5016
(909) 985-2876
(909) 946-8585
Mailing address
553 NORTH MOUNTAIN AVENUE, UPLAND, CA 91786-5016
(909) 985-2876
(909) 946-8585
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
4109T
CA
152W00000X
Optometrist
5933T
CA
152W00000X
Optometrist
8810T
CA
152W00000X
Optometrist
Primary
OPT8810TPA
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
091303
DELTA VISION ID
CA
01
—
09160
SPECTERA
CA
01
—
12993
ID FOR VBA
CA
01
—
1417948092
NPI INDIVIDUAL FOR MINTZ
CA
01
—
16110
RUBIN ID FOR MES VISION
CA
01
—
1871584581
NPI FOR INDIVIDUAL RUBIN
—
01
—
211537
EYMED ID
CA
01
—
3163
MINTZ ID FOR MES VISION
CA
01
—
35021
GVA ID NUMBER
CA
01
—
45941
ID FOR SAFEGUARD
CA
01
—
49103
ID FOR SAFEGUARD PPO
CA
01
—
9V12145
IEHP ID
CA
05
—
SD0041091
—
CA
Enumeration date
10/03/2006
Last updated
09/24/2010
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