Organization
BENNETT A WEINER, OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENNETRT WEINER O.D. (OWNER)
(562) 697-3995
Entity
Organization
Contact information
Practice address
1447 W WHITTIER BLVD, LA HABRA, CA 90631-3614
(562) 697-3995
(562) 697-3446
Mailing address
1447 W WHITTIER BLVD, LA HABRA, CA 90631-3614
(562) 697-3995
(562) 697-3446
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9119T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GSD001180
—
CA
Enumeration date
12/06/2007
Last updated
04/30/2020
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