Individual
JACQUELINE REYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
11696 SAN VICENTE BLVD, LOS ANGELES, CA 90049-5104
(310) 820-2020
Mailing address
11696 SAN VICENTE BLVD, LOS ANGELES, CA 90049-5104
(310) 820-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT35355-TLG
CA
Other
Enumeration date
04/11/2022
Last updated
09/26/2023
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