Individual
CARLA A URSETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
27270 ALICIA PKWY, SUITE, LAGUNA NIGUEL, CA 92677
(630) 841-6549
Mailing address
7407 MELROSE AVE, LOS ANGELES, CA 90046-7514
(323) 653-8176
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046010096
IL
152W00000X
Optometrist
Primary
33344
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1636706
BLUE CROSS BLUE SHIELD
IL
01
—
7235044
AETNA
—
01
—
8825444
MULTIPLAN
—
Enumeration date
09/03/2008
Last updated
09/05/2018
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