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Organization
R ALEX MANCILLA OD PC
Active
Organization
R ALEX MANCILLA OD PC
Active
Other names
Mancilla Family Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
RAUL A MANCILLA OD (PRESIDENT/DOCTOR)
(619) 370-7315
Entity
Organization
Contact information
Practice address
435 W ATEN RD STE 3, IMPERIAL, CA 92251-9819
(619) 370-7315
Mailing address
435 W ATEN RD STE 3, IMPERIAL, CA 92251-9819
(619) 370-7315
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
09/18/2023
Last updated
02/02/2024
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