Organization
MARK VENTOCILLA, O.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK AUGUSTO VENTOCILLA OD (OWNER)
(616) 502-0069
Entity
Organization
Contact information
Practice address
613 E GRAND AVE, ESCONDIDO, CA 92025-4402
(760) 747-7979
(760) 747-7799
Mailing address
613 E GRAND AVE, ESCONDIDO, CA 92025-4402
(760) 747-7979
(760) 747-7799
Taxonomy
Speciality
Code
Description
License number
State
152WP0200X
Pediatric Optometrist
Primary
10435
CA
Other
Enumeration date
05/03/2011
Last updated
03/12/2012
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