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Organization
PUREVISION OPTOMETRY
Active
Organization
PUREVISION OPTOMETRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELSEY NGUYEN (OPTOMETRIST)
(760) 243-2055
Entity
Organization
Contact information
Practice address
14420 BEAR VALLEY RD, VICTORVILLE, CA 92392-5404
(760) 243-2055
Mailing address
14420 BEAR VALLEY RD, VICTORVILLE, CA 92392-5404
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
15268
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15268 TLG
OPTOMETRIST LICENSE
CA
Enumeration date
08/12/2015
Last updated
11/01/2016
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