Individual
STEPHANIE ALINA GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPT
Contact information
Practice address
228 W HOSPITALITY LN STE F2, SAN BERNARDINO, CA 92408-3268
(909) 234-5257
Mailing address
2273 CRESCENT CIR, COLTON, CA 92324-9515
(909) 234-5257
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
40706
CA
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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