Individual
ALEXANDER BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
14425 CHASE ST, PANORAMA CITY, CA 91402-3017
(818) 891-6711
Mailing address
133 S LOS ROBLES AVE UNIT 508, PASADENA, CA 91101-5824
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPT.0003672
CO
152W00000X
Optometrist
Primary
OPT35541-TLG
CA
Other
Enumeration date
05/19/2021
Last updated
09/27/2023
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