Organization
SAN DIEGO OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARTER SHRUM (OWNER)
(858) 454-0033
Entity
Organization
Contact information
Practice address
7701 FAY AVE, LA JOLLA, CA 92037-4310
(858) 454-0033
Mailing address
7701 FAY AVE, LA JOLLA, CA 92037-4310
(858) 454-0033
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
D621
CA
Other
Enumeration date
05/15/2007
Last updated
08/22/2020
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