Individual
IRENE LUIS ANTONIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10011 ADAMS AVE, HUNTINGTON BEACH, CA 92646-4904
(714) 845-2002
(714) 379-3304
Mailing address
1 CVS DRIVE, MAIL STOP #3005, WOONSOCKET, RI 02895
(401) 770-2286
(401) 269-4731
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
42101
CA
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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