Organization
FAMILY OPTOMETRY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL BRIAN FREELAND O.D. (OWNER)
(805) 482-4628
Entity
Organization
Contact information
Practice address
4976 VERDUGO WAY, CAMARILLO, CA 93012-8632
(805) 482-4628
(805) 482-4620
Mailing address
4976 VERDUGO WAY, CAMARILLO, CA 93012-8632
(805) 482-4628
(805) 482-4620
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10886T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0108860
—
CA
Enumeration date
08/30/2007
Last updated
08/30/2007
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