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Organization
SPECTRUM EYECARE OPTOMETRY INC
Active
Organization
SPECTRUM EYECARE OPTOMETRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID ASHLEY SWEARINGEN OD (PRESIDENT AND CFO)
(909) 394-0462
Entity
Organization
Contact information
Practice address
425 W BONITA AVE, SUITE 110B, SAN DIMAS, CA 91773-2541
(909) 394-0462
Mailing address
425 W BONITA AVE, SUITE 110B, SAN DIMAS, CA 91773-2541
(909) 394-0462
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11528T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5892280001
PTAN
CA
01
—
DF7961
RAILROAD GROUP NUMBER
CA
01
—
P00393465
RAILROAD PTAN
CA
01
—
W20601
MEDICARE GROUP NUMBER
CA
Enumeration date
01/18/2007
Last updated
01/10/2012
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