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Organization
LORI J. BENDE, O.D., PROFESSIONAL OPTOMETRIC CORPORATION
Active
Organization
LORI J. BENDE, O.D., PROFESSIONAL OPTOMETRIC CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORI J BENDE O.D. (OPTOMETRIST)
(858) 453-0444
Entity
Organization
Contact information
Practice address
4009 GOVERNOR DR, SAN DIEGO, CA 92122-2522
(858) 453-0444
(858) 453-0471
Mailing address
4009 GOVERNOR DR, SAN DIEGO, CA 92122-2522
(858) 453-0444
(858) 453-0471
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10611T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1264740001
DMERC PIN
—
01
—
OP10611
NHIC ID
—
01
—
W18234
MEDICARE PROVIDER NUMBER
—
Enumeration date
05/08/2008
Last updated
05/08/2008
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